Other Causes of Acute Esophagitis


Malignancy

  • Poorly differentiated carcinomas or hematological malignancies

  • Immunostains can be helpful (EX: p63 stain for squamous cell carcinoma; CD3/CD4/CD20/CD45 for hematologic workup for lymphoma, CK7/CK20 for adenocarcinomas; S100 for melanomas or neural etc)

Amyloidosis

  • Amyloid presents as abundant amorphous eosinophilia material in the lamina propria- often with tissue cracking and tears secondary to tissue processing.

  • Helpful stains: Congo red stain (bright orangey-pink on direct light; apple-green color when polarized)

  • Amyloid deposition in the blood vessels can cause considerable bleeding.



Radiation

  • Large, bizarre cells with an overall preserved N:C ratio (still has a lot of cytoplasm)

Vasculitis

  • Due to any process that compromises the blood supply (See posts on vasculitides & systemic infiltrative processes such as scleroderma & amyloidosis)


Source of Histology images: Atlas of Gastrointestinal Pathology. Christina Arnold. Esophagus chapter- Acute Esophagitis


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