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Diffuse Esophageal Erosion
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Diffuse Esophageal Erosion

Esophagus has been opened and is attached to opened proximal stomach
A small amount of intact smooth white esophageal mucosa (arrow)is still present, but the majority of the red granular surface represents mucosal erosion.
The red color represents inflamed submucosa
(Description By:Melinda Sanders,M.D. )
(Image Contrib. by:Melinda Sanders,M.D. UCHC )
Erosion
Etiology

Multiple etiologies exist for irritation of the esophageal mucosa causing microscopic and clinical esophagitis
The most frequent are: peptic irritation (gastroesophageal reflux disease (GERD) or nonGERD); infectious (viral, fungal or bacterial); toxic (chemical, cytotoxic chemotherapy); irritants (alcohol, smoking, hot fluids and foodstuffs0
Pathogenesis

In the U.S. peptic irritation is the major cause and this involves exposure of epithelium to the caustic effect of acid
An increasingly common occurrence is fungal or less commonly viral superinfection in an immunocompromised host either due to primary immunodeficiency or secondary to chemotherapy
Epidemiology

Great variation in incidence exists geographically ranging from estimates of 5-10% in the U.S. to 80% in Iran
In the U.S. the primary cause is gastroesophageal reflux (GERD) while in France it is alcohol consumption and in Iran and the far east dietary
General Gross Description

The gross appearance will vary dependant on the etiology
The common finding is evidence of inflammation with reddening,exudate, debris, possible slight edema and in severe cases erosion or ulceration
In fungal esophagitis, most commonly Candida, multiple white patches are seen similar to oral thrush
In Herpes or CMV punched out ulcers are seen
Radiation will show evidence of epithelial atrophy with thinning rather than signs of inflammation and in late cases narrowing leading to stricture
General Microscopic Description

Dependent on etiology.
Clinical Correlation

Dependent on etiology.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 761-2.
Erosion
Synopsis by: Martin Nadel M.D. (T62000M14110)[380]
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