Surgical Pathology Criteria

Eosinophilic Esophagitis

Differential Diagnosis

Gastroeophageal Reflux vs Eosinophilic Esophagitis

Intraepithelial Eosinophils Diagnosis
≥15-20/HPF Marked intraepithelial eosinophilia consistent with eosinophilic esophagitis if other causes are ruled out (see below)
5-14/HPF Indeterminate for eosinophilic esophagitis
<5/HPF Consistent with reflux
Eosinophils are assessed in the single most involved field

 

Eosinophilic GI disorders by location

Eosinophilic Esophagitis Eosinophilic Gastroenteritis Eosinophilic Proctocolitis
Confined to esophagus Involves stomach and/or small intestine Confined to rectum and colon
Good response to dietary manipulation Poor response to dietary manipulation Good response to dietary manipulation

 

Eosinophils may be numerous in other diseases

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