SAVED
File name
.JPG
File alt. text
Image should be
px wide x
px tall.
Select Image
Select Image
L
O
G
I
N
EXISTING USERS
NEW USERS
password:
Forgotten your password?
password:
LOG IN
REGISTER
The Gastroenterology Training Handbook
For Specialist Registrars
HOME
OESOPHAGUS
•Gastro Oesophageal Reflux Disease
•Oesophageal Cancer
•Oesophageal Dysmotility
•Benign Oesophageal Lesions
•Miscellaneous
•Dysphagia
STOMACH
•Obesity Surgery
•Clinical Presentations of Gastric Conditions
•Gastric Cancer
•Gastric Polyps and Masses
•Peptic Ulcer Disease
•Gastritis and Gastropathy
•Miscellaneous
SMALL BOWEL
•Coeliac Disease
•Small Bowel Infections
•Small Bowel Masses
•Miscellaneous
COLON
•Colorectal and Anal Cancer
•Diagnostic Pathways for Colonic Disease
•Colonic Vascular Disorders
•Anal Diseases
•Various Colitides
•Colonic Motility Disorders
•Miscellaneous
•Colonic Infection
LIVER
•Alcohol
•Liver Failure
•Miscellaneous
•Ascites
•Bilirubin Metabolism
•Vascular Problems
•Clinical Presentations
•Liver Masses
•Hepatitis B
•Hepatitis C
•Autoimmune Conditions
•Metabolic Conditions
•Treatments
•Various Viruses
•Hepatopulmonary Disorders
•Liver Imaging
BILIARY
•Gallstone Disease
•Biliary Cancers
•Biliary Parasites
•Miscellaneous
NUTRITION
•Nutrition Therapy
•Minerals
•Proteins, Fats and Sugars
•Vitamins
•Clinical Conditions and Nutrition
PANCREAS
•Pancreatitis
•Pancreatic Masses and Cysts
•Pancreatic Cancers
•Other
IBD
•Epidemiology
•IBD Diagnosis
•Extra Intestinal Manifestations
•Surgery
•Treatment
MISCELLANEOUS
•Bleeding
•Rheumatological Disease
•Infection
•Vascular Lesions
•Other
home -
Oesophagus -
Benign Oesophageal Lesions -
Benign Flat Lesions
search
Ask a question in the forum
Written by Dr Sebastian Zeki
MCQs for this page
Benign Flat Lesions
View large version
Embed image
paste this code into your webpage / blog to share.
Written by Dr Sebastian Zeki
Histology:
Multifocal plaques of hyperplastic squamous
epithelium with abundant intracellular glycogen.
Lugol's solution, which turns plaques dark brown,
so distinguishing from leukoplakia, monoliasis,
and bullous
pemphigoid,
all of which can have a
similar endoscopic appearance.
Complications of inlet patches:
Perforation and a
tracheoesophageal
fistula
occurring at the site of an inlet patch.
Dysphagia commonly from strictures, rings, and
webs associated with the patch.
Can get H. pylori in 75% who have H. pylori in
the stomach.
20 % also have Barrett’s.
Endoscopic Features Of Inlet
Patches
The patches range in size from 2 mm to 4.5 cm
and can be solitary or multiple.
They are usually red, velvety and flat.
Histological Feature of Inlet
Patches:
Corpus or fundic-type gastric mucosa, sometimes
with parietal cells capable of secreting acid.
Also have an associated inflammatory infiltrate.
Pathogenesis
Embryonic (not heterotopic) gastric mucosa with
glucagon reactive cells only seen in embryonic
form
BUT...
More closely resemble Barrett's mucosa rather
than normal gastric mucosa, making a congenital
origin seem less likely.
Histological Features of Parakeratosis:
Epithelial
acanthosis.
Basal hyperplasia.
Dense, compact layer of parakeratosis, featuring cytoplasmic eosinophilia and
pycnotic nuclei, covered by an outer layer of nonnucleated squamous cells.
Associations of parakeratosis:
Head and neck cancers.
Submucosal fibrosis of the oral cavity, esp smokers and betel nut chewers.
Parakeratosis
Glycogen acanthosis
It is more common in males than females.
It occurs in 40s and 50s.
It occurs in 10% of all upper endoscopies.
Endoscopic
features typically
involve
multiple, uniformly sized round elevations
in otherwise normal-appearing mucosa,
Lesions are usually in the midportion of the
oesophagus.
Lesions can be up to 1cm.
Associations
include
Cowden's disease and
coeliac.
Patients are usually asymptomatic.
Flat Oesophageal Lesions
Heterotopic sebaceous
glands
May represent reactive metaplasia of ectopic,
pluripotent salivary type mucous glands in the
oesophagus that were initially displaced during
embryonic development.
Endoscopy
shows
yellowish gray, plaque-like
lesions that resemble xanthelasmas.
Lesions frequently occur in clusters, with several
cases of up to 100 reported in the literature.
Histological features include
lobules of cells with
sebaceous differentiation within the lamina
propria.
The lesions have no known malignant potential.
Inlet patch
It is defined as a heterotopic gastric mucosa of
the upper oesophagus.
It is found in the proximal 3cm oesophagus.
The population prevalence is 5%.
It is often seen in children and prevalence
doesnt increase with age.
It is usually asymptomatic.
No treatment is necessary,
occasionally PPI can
be useful.
Endoscopic features of parakeratosis:
Endoscopy shows whitish,
membranous
linear plaques.
Related Stories
•
•
•
•
•