High prevalence of esophageal involvement in lichen planus: a study using magnification chromoendoscopy
| Autor: | O. S. van Boxel, A. J. P. M. Smout, Melvin Samsom, Matthijs P. Schwartz, Rutger Quispel, Vigfus Sigurdsson, Marguerite E.I. Schipper, A. Kerckhoffs, M. R. Canninga-van Dijk |
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| Přispěvatelé: | Other departments |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
Pathology medicine.medical_specialty Civatte bodies Esophageal Neoplasms Malignancy Chromoendoscopy Esophagus stomatognathic system medicine Prevalence Humans Endoscopy Digestive System Prospective Studies skin and connective tissue diseases medicine.diagnostic_test integumentary system business.industry Gastroenterology Lichen Planus Middle Aged medicine.disease Dermatology Endoscopy stomatognathic diseases medicine.anatomical_structure Dysplasia Histopathology Female business Esophagitis Precancerous Conditions |
| Zdroj: | Endoscopy, 41(3), 187-193. Georg Thieme Verlag |
| ISSN: | 0013-726X |
| Popis: | BACKGROUND AND STUDY AIMS: The first cases of squamous cell carcinoma in esophageal lichen planus were recently described. We performed a study to establish the prevalence of endoscopic and histopathologic abnormalities consistent with lichen planus and (pre-) malignancy in a cohort of patients with lichen planus. PATIENTS AND METHODS: A total of 24 patients with lichen planus were prospectively studied using high-magnification chromoendoscopy. Focal esophageal abnormalities were mapped, classified, and biopsied. Biopsies were also taken from normal-appearing esophageal mucosa at three levels (proximal, middle, and distal). The presence of a lymphohistiocytic interface inflammatory infiltrate and Civatte bodies (i. e. apoptotic basal keratinocytes) at histopathologic examination was considered diagnostic for esophageal lichen planus. Symptoms were assessed using validated questionnaires. RESULTS: A total of 38 focal abnormalities were biopsied. These consisted of: layers of mucosa peeling off, hyperemic lesions, papular lesions, submucosal plaques/papules, a flat polypoid lesion, and segments of cylindrical epithelium. No endoscopic signs of dysplasia were present. Esophagitis consistent with gastroesophageal reflux disease was noted in 12 / 24 patients. Histopathology showed chronic inflammation of the esophageal mucosa in the majority (18 / 24) of patients. In 50 % (12 / 24), the diagnosis of esophageal lichen planus was made. Dysplasia was not present. There were no differences in symptoms between patients with and without esophageal lichen planus. CONCLUSIONS: At screening endoscopy a high prevalence (50 %) of esophageal lichen planus was found in patients with orocutaneous lichen planus. No dysplasia was found. |
| Databáze: | OpenAIRE |
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