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- Title
Comparative utility of distal and mid esophageal biopsies in the diagnosis of eosinophilic esophagitis: A retrospective analysis.
- Authors
Kubica, Matthew; Alkhattabi, Maan; Gregor, James; Driman, David
- Abstract
Objective: Eosinophilic esophagitis (EE) is characterized clinically by food impaction, dysphagia, and reflux-like symptoms, and its differentiation from reflux esophagitis depends largely on the basis of endoscopic appearance and intraepithelial eosinophil count. While there are accepted histological criteria for the diagnosis of EE, there is little data on whether this diagnosis can reliably be made on the basis of eosinophil count from a single biopsy site or whether distal biopsies alone are useful. This study aims to evaluate the comparative utility of mid and distal esophageal biopsies in the diagnosis of EE. Methods: Specimens were retrieved from a single institution spanning a three-year period. The specimen database was queried for all cases that included esophageal biopsies. Those cases with a mid and distal biopsy specimen taken from adult patients were flagged for possible inclusion. Clinical diagnoses and pathology reports were used to identify cases of EE. Sections from cases of EE were manually reevaluated for the presence of eosinophils, and the maximum eosinophil count per hpf was recorded. Results: Biopsies from 126 cases of EE were evaluated. Maximum eosinophil counts in the distal esophagus exceeded those in the mid esophagus in a majority of cases. The mean number of eosinophils in the distal and mid esophageal biopsies was 54 and 47 per high power field, respectively. Conclusions: In cases of EE, average eosinophil counts are higher in the distal esophagus. Our data suggest that a biopsy from the distal esophagus alone may provide sufficient information for the diagnosis of EE.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p40
- ISSN
1918-915X
- Publication type
Article