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Pathology of Infectious Esophagitis:

A Histopathologic Study of 157 Cases

Satoshi N IMURA

1）, 2）

, Hideki I SHIBASHI

3）

, Yoshiyuki K AYASHIMA

3）

, Takashi W ATANABE

3）

, Mamoru N AKAMURA

4）

, Masahiro K AWAKAMI

5）

,

Ikuro K OBA

6）

, Shotaro S AKISAKA

3）

, Kazuki N ABESHIMA

1）, 2）

, and Morishige T AKESHITA

1）, 2）

1）

Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

2）

Department of Pathology, Fukuoka University Hospital, Fukuoka, Japan

3）

Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

4）

Internal Medicine, Suihoku Daiichi Hospital, Fukuoka, Japan

5）

Gastroenterology and Medicine, Nagasaki Prefecture Tsushima Hospital, Nagasaki, Japan

6）

Gastroenterology and Medicine, Yamaga Chuo Hospital, Kumamoto, Japan

Abstract

The aim of this study was to clarify the pathological features of infectious esophagitis. We studied 157 cases with infectious esophagitis （Candida, herpes simplex virus, cytomegalovirus, and Mycobacterium tuberculosis:

138, 12, 6, and 1 case, respectively） . The following conclusions were obtained. Infectious focus of candida and herpes simplex virus is limited to the esophagus. On the other hand, cytomegalovirus involved multiple organs. Macroscopically, candidal esophagitis appeared as elevated yellow-white plaques. Herpes simplex virus and cytomegalovirus-induced esophageal lesions consisted of well-demarcated ulcers of varying size.

Histologically, candidal organisms were identified in the stratified squamous epithelium of the esophageal mucosa. Foci demonstrating the cellular changes characteristic of herpetic infection were detected in the squamous epithelium. On the other hand, cytopathic effects associated with cytomegalovirus-infection were observed in the mesenchymal cells such as fibroblasts and small vascular endothelial cells. We conclude that for the pathological diagnosis of infectious esophagitis, careful detection of the presence or absence of cytohistologic findings that are characteristic of each infectious disease is important in addition to referring to clinical information such as the underlying disease or drug history.

Key words: Infectious esophagitis, Diagnostic pathology

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