Document Type : Original Research

Authors

1 Department of Pathology, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Pathology, School of Medicine, Shohada-e-Tajrish Hospital, Tehran, Iran

Abstract

Background & Objective: Eosinophils are normally found in different parts of the gastrointestinal tract and with less prevalence in the esophagus. Eosinophilic infiltration is increased as part of inflammatory reactions in various diseases. The aim of this study was to determine the count and distribution of eosinophils in esophageal specimens obtained for different causes.
Methods: Endoscopy and pathology reports of esophageal specimens in Shahid Beheshti University related hospitals, Tehran, Iran, were extracted from 2016 to 2019. The prevalence of gastroesophageal reflux disease (GERD), malignancy, eosinophilic esophagitis, and asymptomatic patients were determined as the percentages of total resection and biopsy specimens. Each group was calculated and randomly selected according to the inclusion criteria. All data were analyzed statistically using SPSS software.
Results: A total of 258 biopsy and resection specimens were evaluated in this study. Fourty three  cases (16.7%) diagnosed as normal esophageal mucosa , 42 cases (16.3%) as  non-specific esophagitis, 155 cases (60.1%) diagnosed as gastroesophageal reflux disease, 4 cases (1.6%) showed  malignancy and  other diagnoses were recorded for 14 cases (5.4%). The numbers of eosinophils in the epithelium and lamina propria  in the normal group were 0.1±0.5 and 2.08±2.33, respectively. The eosinophil count in different groups and its relation to different histopathologic findings were diverse.
Conclusion: The number of eosinophils within  the lamina propria was significantly higher than those found within other layers. . The highest mean eosinophil count was observed in the epithelium and the lamina propria  of cases diagnosed as GERD.

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  1. Travers J, Rothenberg M. Eosinophils in mucosal immune responses. Mucosal Immunol. 2015;8(3):464-75. [DOI:10.1038/mi.2015.2] [PMID] [PMCID]
  2. Yantiss RK. Eosinophils in the GI tract: how many is too many and what do they mean? Mod pathol. 2015;28(1):S7-S21. [DOI:10.1038/modpathol.2014.132] [PMID]
  3. Shamri R, Xenakis JJ, Spencer LA. Eosinophils in innate immunity: an evolving story. Cell Tissue Res. 2011;343(1):57-83. [DOI:10.1007/s00441-010-1049-6] [PMID] [PMCID]
  4. Rothenberg ME, Hogan SP. The eosinophil. Annu Rev Immunol. 2006;24:147-74. [DOI:10.1146/annurev.immunol.24.021605.090720] [PMID]
  5. Rosenberg HF, Dyer KD, Foster PS. Eosinophils: changing perspectives in health and disease. Nature Reviews Immunology. 2013;13(1):9-22. [DOI:10.1038/nri3341] [PMID] [PMCID]
  6. Lee JJ, Jacobsen EA, McGarry MP, Schleimer RP, Lee NA. Eosinophils in health and disease: the LIAR hypothesis. Clin Exp Allergy. 2010;40(4):563-75. [DOI:10.1111/j.1365-2222.2010.03484.x] [PMID] [PMCID]
  7. Mishra A, Hogan SP, Lee JJ, Foster PS, Rothenberg ME. Fundamental signals that regulate eosinophil homing to the gastrointestinal tract. J Clin Investig. 1999;103(12):1719-27. [DOI:10.1172/JCI6560] [PMID] [PMCID]
  8. DeBrosse CW, Case JW, Putnam PE, Collins MH, Rothenberg ME. Quantity and distribution of eosinophils in the gastrointestinal tract of children. Pediatr Dev Pathol. 2006;9(3):210-8. [DOI:10.2350/11-05-0130.1] [PMID]
  9. Kiss Z, Tél B, Farkas N, Garami A, Vincze Á, Bajor J, et al. Eosinophil counts in the small intestine and colon of children without apparent gastrointestinal disease: a meta-analysis. J Pediatr Gastroenterol Nutr. 2018;67(1):6-12. [DOI:10.1097/MPG.0000000000001904] [PMID]
  10. Matsushita T, Maruyama R, Ishikawa N, Harada Y, Araki A, Chen D, et al. The number and distribution of eosinophils in the adult human gastrointestinal tract: a study and comparison of racial and environmental factors. Am J Surg Pathol. 2015;39(4):521-7. [PMID] [DOI:10.1097/PAS.0000000000000370]
  11. Zuo L, Rothenberg ME. Gastrointestinal eosinophilia. Immunol Allergy Clin North Am. 2007;27(3):443-55. [PMID] [PMCID] [DOI:10.1016/j.iac.2007.06.002]
  12. Rothenberg ME. Molecular, genetic, and cellular bases for treating eosinophilic esophagitis. Gastroenterology. 2015;148(6):1143-57. [PMCID] [DOI:10.1053/j.gastro.2015.02.002] [PMID]
  13. Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011;140(6):1785-94. e4. [DOI:10.1053/j.gastro.2011.01.055] [PMID]
  14. Lowichik A, Weinberg A. A quantitative evaluation of mucosal eosinophils in the pediatric gastrointestinal tract. Mod Pathol. 1996;9(2): 110-4.