(BQ) Part 2 book "Rubin's pathology - Clinicopathologic foundations of medicine" presentation of content: The gastrointestinal tract, the liver and biliary system, the pancreas, the kidney, the endocrine system, the head and neck, the central nervous system, forensic pathology,. and other contents. | CHAPTER 19: THE GASTROINTESTINAL TRACT A 757 B C D and prominent degranulation of eosinophils (Fig. 19-7B). Deeper samples may show subepithelial fibrosis and eosinophils in the lamina propria. CLINICAL FEATURES: Eosinophilic esophagitis can present at any age and is more common in males. Adults typically complain of dysphagia to solids or food impaction, while young children may show food intolerance, vomiting, feeding difficulties or failure to thrive. Many patients have a personal or family history of atopy (asthma, allergic rhinitis, eczema, atopic dermatitis), and some may have mildly increased blood eosinophils. Eliminating inciting food from the diet can lead to remission in many patients. Swallowed corticosteroids, leukotriene inhibitors and other immunomodulators can also be used to treat eosinophilic esophagitis. Lymphocytic Esophagitis Is an Emerging Form of Esophagitis This rare entity is defined by marked esophageal lymphocytosis in peripapillary zones, with rare or absent granulocytes. Intercellular edema is frequent. Patients present with a variety of clinical symptoms, and no specific underlying etiology is known. Infective Esophagitis Is Associated with Immunosuppression CANDIDA ESOPHAGITIS: This fungal infection became common as increasing numbers of patients are immunocompromised owing to chemotherapy for malignant disease, immunosuppression after organ transplantation or AIDS. THE GASTROINTESTINAL TRACT FIGURE 19-6. Barrett esophagus. A. The presence of the tan tongues of epithelium interdigitating with the more proximal squamous epithelium is typical of Barrett esophagus. B. The specialized epithelium has a villiform architecture and is lined by cells that are foveolar gastric-type cells and intestinal goblet-type cells. C. High-grade dysplasia. Markedly dysplastic glands predominate with hyperchromatic nuclei and early architectural distortion. Intestinalized, nondysplastic glands persist (arrow). D. Intramucosal adenocarcinoma. Malignant .
