1/34. Heterotopic sebaceous glands in the esophagus: histopathological and immunohistochemical study of a resected esophagus.A resected esophagus with numerous heterotopic sebaceous glands was examined in an attempt to determine whether esophageal heterotopic sebaceous glands are the result of a metaplastic process or a congenital anomaly. The present case concerns a 79-year-old Japanese man with numerous esophageal heterotopic sebaceous glands accompanied by superficial esophageal cancer. The resected esophagus possessed numerous heterotopic sebaceous glands, which could be seen clearly as slightly elevated, yellowish lesions. Histological examination of these glands, all of which were located in the lamina propria, revealed lobules of cells that showed characteristic sebaceous differentiation. Bulbous nests of proliferating basal cells showing sebaceous differentiation were occasionally observed in the esophageal epithelium. Of the antibodies against six different keratins used, only anti-keratin 14 labeled both the heterotopic sebaceous glands and the bulbous nests. Acquired metaplastic change of the esophageal epithelium is probably the pathogenetic mechanism involved in these unusual lesions.- - - - - - - - - - ranking = 1keywords = propria (Clic here for more details about this article) |
2/34. oral manifestations as a hallmark of malignant acanthosis nigricans.We present a case of malignant acanthosis nigricans (AN) that initially manifested in the oral cavity. In the present report, the patient had typical clinical and histological findings of oral and esophageal AN, with subtle skin changes, associated with a gallbladder adenocarcinoma. The importance of the clinical oral examination is emphasized because the recognition of oral lesions led to the diagnosis of AN and to the following detection of the internal malignancy. Since the tumours associated with AN are highly malignant, it is of the utmost importance to recognize the skin and mucous membrane changes in adults.- - - - - - - - - - ranking = 0.0050903455976701keywords = membrane (Clic here for more details about this article) |
3/34. diagnosis of esophageal ulcers in acquired immunodeficiency syndrome.The esophagus is one of the most common sites of gastrointestinal involvement in human immunodeficiency virus (HIV)-infected patients, with at least 30% of the patients having esophageal symptoms at some point during the course of HIV infection. Esophageal ulcers are commonly caused by infections such as cytomegalovirus (CMV) or may be idiopathic. The clinical presentation of the various causes of esophageal ulcers are similar; therefore, a thorough endoscopic and histological workup is imperative to make a diagnosis and, consequently, to provide appropriate therapy. The widespread use of more effective antiretroviral therapy appears to have led to a decline in gastrointestinal opportunistic disorders in patients with acquired immunodeficiency syndrome (AIDS), including those involving the esophagus. Unfortunately, there are several reports of resistance of hiv-1 to multiple antiretroviral agents, and thus it is possible we will observe an increase in various opportunistic disorders again. The aim of this article is to provide a practical approach to the clinical, endoscopic, and histopathologic evaluation of esophageal ulcers in patients with AIDS.- - - - - - - - - - ranking = 1keywords = propria (Clic here for more details about this article) |
4/34. Oesophageal lichen planus.We present a case of lichen planus affecting the oesophagus of an 80-year-old woman. Symptomatically, the lesions manifested themselves as dysphagia requiring repeated oesophageal dilatations. The patient was unable to tolerate several conventional treatments and so pulsed methylprednisolone was given with some beneficial short-term effects. Due to potential for malignant change in lichen planus of the mucous membranes it is important to remember this complication and investigate patients with oesophageal symptoms.- - - - - - - - - - ranking = 0.0050903455976701keywords = membrane (Clic here for more details about this article) |
5/34. Use of "Gore-Tex surgical membrane" to minimize surgical adhesions in multistaged extrathoracic esophageal elongation for esophageal atresia.The procedure of choice in the surgical correction of "long gap" esophageal atresia should, when possible, preserve the native esophagus. We present a modification of "the multistaged extrathoracic esophageal elongation method," designed to facilitate esophageal elongation and use of a Gore-Tex (W.L. Gore and Associates, Flagstaff, AZ) surgical membrane to minimize surgical adhesions. We used this technique to successfully treat a 1-kg infant, with type A esophageal atresia, associated aortic coartation, and severe necrotizing enterocolitis with multiple perforations. Multistaged extrathoracic esophageal elongation was begun at the age of 9 months and concluded at 17 months.- - - - - - - - - - ranking = 0.02545172798835keywords = membrane (Clic here for more details about this article) |
6/34. Simplified access for division of the low cervical/high thoracic H-type tracheoesophageal fistula.H-type tracheoesophageal fistulas (H-TEF) often are located in the low cervical/high thoracic region where determination of the most appropriate surgical approach is difficult. When it can provide adequate exposure, a cervical incision is preferred because of the likelihood of decreased morbidity. A child with VACTERL association presented with recurrent respiratory problems. Esophagogram showed an H-TEF below the level of the clavicle. A vascular guide wire was placed through the H-TEF with the ends brought out through the mouth. Under fluoroscopic guidance, gentle traction was placed on the wire to bring the fistula into the neck for an easily accessible cervical exposure, thus eliminating the need for a thoracotomy.- - - - - - - - - - ranking = 1keywords = propria (Clic here for more details about this article) |
7/34. GI polyposis and glycogenic acanthosis of the esophagus associated with PTEN mutation positive Cowden syndrome in the absence of cutaneous manifestations.A 62-yr-old man was referred for management of GI polyposis. Large bowel polyps were initially diagnosed >25 yr ago, and the patient had undergone multiple colonoscopies and polypectomies. Personal and family history were notable for thyroid goiter and hypothyroidism. physical examination was notable for lingular papillomatosis. No cutaneous lesions were seen. Upper endoscopy revealed esophageal glycogen acanthosis. There were multiple polyps throughout the stomach and the small and large intestines. histology of these polyps showed multiple cell types including juvenile polyps, inflammatory polyps with fibromuscular proliferation and lamina propria ganglion cells, and focal adenomatous change. A clinical diagnosis of Cowden syndrome was made. mutation analysis revealed a variant in exon 8 of the PTEN gene. Direct sequencing revealed a germline heterozygous C.892-895InsA, which is predicted to result in a truncated PTEN protein. Cowden syndrome is an underdiagnosed, underrecognized, autosomal dominant, inherited syndrome. For the gastroenterologist, esophageal acanthosis and multiple hamartomatous polyps should suggest the diagnosis. Sensitive molecular diagnostic tests looking for mutations in the appropriate genes are clinically available. Together with genetic counseling, molecular diagnostic testing will allow more accurate risk assessment and surveillance for cancer for both the patient and family members.- - - - - - - - - - ranking = 2keywords = propria (Clic here for more details about this article) |
8/34. Upper aerodigestive tract complications in a neonate with linear iga bullous dermatosis.linear iga bullous dermatosis (LABD) is a rare immunobullous condition known to affect the skin and mucous membranes of the eye and oral cavity in adults and young children. We describe a newborn with skin involvement who had life-threatening respiratory compromise from disease affecting the larynx, subglottis, trachea, and esophagus. Management with both tracheostomy and gastrostomy tube placement was necessary. Treatment included systemic steroids, dapsone, and intravenous immunoglobulin. We compare our neonatal case to the only other report in the literature highlighting involvement of the mucous membranes of multiple levels of the aerodigestive tract leading to respiratory compromise.- - - - - - - - - - ranking = 0.01018069119534keywords = membrane (Clic here for more details about this article) |
9/34. Spontaneous intramural esophageal hematoma.Spontaneous intramural esophageal hematoma is a rare cause of chest pain. Erroneous diagnosis may cause inappropriate management and disaster. We describe one case of spontaneous intramural hematoma that was successfully managed by conservative treatment. Endoscopic and radiographic images are reviewed. The benefit of endoscopic ultrasound is emphasized.- - - - - - - - - - ranking = 1keywords = propria (Clic here for more details about this article) |
10/34. Spontaneous esophageal submucosal hematoma in which the course could be observed endoscopically.A 66-year-old man was hospitalized after vomiting blood after inducing vomiting using his fingers due to laryngeal discomfort. Upper digestive tract endoscopy revealed a large, dark red mass that connected from the upper esophagus to the lower esophagus. Esophageal submucosal hematoma was diagnosed using endoscopy, X-ray images, a small-diameter ultrasonic probe, and chest CT scanning. Pain from the epigastrium to the larynx disappeared after 3 days. melena occurred on Day 3. Endoscopic examination revealed that the hematoma had collapsed over a wide area. Endoscopic examination after one week showed that the mucous membrane covering the hematoma had peeled away revealing an extensive shallow ulcer in the esophagus. Endoscopic examination after one month confirmed the ulcer had scarred and healed.- - - - - - - - - - ranking = 0.0050903455976701keywords = membrane (Clic here for more details about this article) |
| | Next -> |