PMID- 28296675
OWN - NLM
STAT- MEDLINE
DCOM- 20170424
LR  - 20170424
IS  - 1532-0979 (Electronic)
IS  - 0147-5185 (Linking)
VI  - 41
IP  - 5
DP  - 2017 May
TI  - Eosinophilic Esophagitis and Esophageal Granular Cell Tumor: An Unexpected 
      Association.
PG  - 616-621
LID - 10.1097/PAS.0000000000000832 [doi]
AB  - Esophageal granular cell tumors (GCTs) are rare. Eosinophilic esophagitis (EoE) 
      is an immune-mediated disease characterized by esophageal eosinophilia despite 
      proton pump inhibitor (PPI) therapy. Given that GCTs occur at sites of scarring 
      and inflammation, we sought to determine the prevalence of EoE in patients with 
      esophageal GCTs. Our center's pathology database was searched for GCT specimens 
      from 1995 to 2014. Slides were blindly rereviewed. GCTs were scored for atypical 
      cytological features. Presence and number of eosinophils in the tumor and the 
      surrounding esophageal epithelium and any EoE features were recorded. Medical 
      records were reviewed. From >30,000 esophageal cases, 23 esophageal GCTs were 
      identified, with 18 available for review (16 adult, 2 pediatric). Median patient 
      age was 38.7 years. Four adults had esophageal intraepithelial eosinophilia (peak 
      38 to 68 eosinophils/high power field [HPF]); 2 confirmed to have EoE, 1 with 
      PPI-responsive esophageal eosinophilia, and 1 had not received PPI therapy. Both 
      pediatric cases had confirmed EoE (peak 24 and 34 eosinophils/HPF). In total, 
      12/18 GCTs had intratumoral eosinophilia (peak 1 to 16 eosinophils/HPF). All 6 
      cases with esophageal eosinophilia had intratumoral eosinophilia. Two GCTs 
      displayed atypical cytologic features. Esophageal eosinophilia was present in 25% 
      of adult and 100% of pediatric GCTs, the majority confirmed to have EoE. Overall, 
      67% of cases had intratumoral eosinophilia and 2 had atypical features. On the 
      basis of these findings, we propose evaluating surrounding tissue for 
      eosinophilia when esophageal GCT is diagnosed, and adding GCT as a potential 
      complication of untreated EoE. Research for an immunologic link between EoE and 
      esophageal GCTs is needed.
FAU - Riffle, Mary Ellen
AU  - Riffle ME
AD  - Department of *Pediatrics, Mount Sinai Center for Eosinophilic Disorders, Jaffe 
      Food Allergy Institute daggerPathology, Icahn School of Medicine at Mount Sinai, New 
      York, NY.
FAU - Polydorides, Alexandros D
AU  - Polydorides AD
FAU - Niakan, Jessica
AU  - Niakan J
FAU - Chehade, Mirna
AU  - Chehade M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Surg Pathol
JT  - The American journal of surgical pathology
JID - 7707904
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (S100 Proteins)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biomarkers, Tumor/analysis
MH  - Biopsy
MH  - Databases, Factual
MH  - Eosinophilic Esophagitis/*complications/drug therapy/pathology
MH  - Eosinophils/*pathology
MH  - Esophageal Neoplasms/chemistry/*complications/pathology
MH  - Esophagoscopy
MH  - Female
MH  - Granular Cell Tumor/chemistry/*complications/pathology
MH  - Humans
MH  - Immunohistochemistry
MH  - Male
MH  - Middle Aged
MH  - New York City
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Retrospective Studies
MH  - S100 Proteins/analysis
EDAT- 2017/03/16 06:00
MHDA- 2017/04/25 06:00
CRDT- 2017/03/16 06:00
PHST- 2017/03/16 06:00 [pubmed]
PHST- 2017/04/25 06:00 [medline]
PHST- 2017/03/16 06:00 [entrez]
AID - 10.1097/PAS.0000000000000832 [doi]
PST - ppublish
SO  - Am J Surg Pathol. 2017 May;41(5):616-621. doi: 10.1097/PAS.0000000000000832.