Eosinophilic Esophagitis
Definition
- Marked eosinophil infiltration restricted to the esophagus
Alternate/Historical Names
- Allergic esophagitis
Diagnostic Criteria
- Intraepithelial eosinophils at least 15/HPF in any one field (Furuta)
- 6-14/HPF is considered indeterminate
- The specificity of such cutoffs has been challenged (Rodrigo)
- Eosinophils may be diffuse or in clusters
- Microabscess is defined as a cluster of 4 or more
- Eosinophils often located in superficial layers of mucosa
- Superficial epithelium containing sheets of eosinophils may slough
- Eosinophilic infiltrates must not be present in rest of GI tract
- Generalized GI infiltrates should suggest eosinophilic gastroenteritis
- Peripheral eosinophilia may be present but usually <1500/ml
- Report should contain the following
- Number of eosinophils/HPF
- Presence or absence of microabscesses
- Distribution: diffuse or accentuated at surface
- Presence or absence of squamous hyperplasia
- Papillary or basal cell
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting/updates : 11/11/09, 11/11/11
