No transformation of a fundic gland polyp with dysplasia into invasive carcinoma after 14 years of follow-up in a proton pump inhibitor-treated patient: A case report

2018 ◽  
Vol 68 (12) ◽  
pp. 706-711 ◽  
Author(s):  
Masahide Fukuda ◽  
Hirohito Ishigaki ◽  
Hiromitsu Ban ◽  
Mitsushige Sugimoto ◽  
Eri Tanaka ◽  
...  
Keyword(s):  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Invasive Carcinoma ◽  
Treated Patient ◽  
Fundic Gland ◽  
Fundic Gland Polyp

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

Fundic Gland Polyp With Parietal Cell Vacuolation Mimicking Signet Ring Cell Carcinoma

2021 ◽  
pp. 106689692199418
Author(s):  
John D. Coyne ◽  
S. Thampy
Keyword(s):  
Proton Pump Inhibitor ◽  
Cell Carcinoma ◽  
Parietal Cell ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Fundic Gland ◽  
Fundic Gland Polyp ◽  
Signet Ring ◽  
Ring Cell

Pseudo-signet ring parietal cell vacuolation has been described as a mimic of invasive signet ring cell carcinoma. Moreover, signet ring cell carcinoma has been described in a fundic gland polyp. This case demonstrates parietal cell vacuolation in a fundic gland polyp in a patient on a long-term proton pump inhibitor.

Empiric proton pump inhibitor therapy after esophageal food impaction may mask eosinophilic esophagitis diagnosis at follow-up

2021 ◽  
Author(s):  
Luke Hillman ◽  
Sarah Donohue ◽  
Aimee Teo Broman ◽  
Patrick Hoversten ◽  
Eric Gaumnitz ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Empiric Therapy ◽  
Proton Pump Inhibitor Therapy ◽  
Significant Heterogeneity ◽  
Food Impaction ◽  
Esophageal Food Impaction ◽  
The Impact

Summary Esophageal food impaction (EFI) is often the first presentation for patients with eosinophilic esophagitis (EoE); however, there is significant heterogeneity in the management of EFI. We aimed to study the impact of EFI management, particularly post-EFI medication prescriptions on EoE diagnosis, follow-up, and recurrence in patients with endoscopic features of EoE. In our retrospective study, adults presenting between 2007 and 2017 with EFI requiring endoscopic dis-impaction with endoscopic features of EoE (furrows, rings, and/or exudates) were included. We examined the impact of demographics and EFI management on EoE diagnosis, follow-up (esophagogastroduodenoscopy [EGD] or clinic visit within 6 months), and recurrence. We identified 164 cases of EFI due to suspected EoE. Biopsy was performed in 68 patients (41.5%), and 144 patients (87.8%) were placed on proton pump inhibitor (PPI) and/or swallow corticosteroids after EFI, including 88.5% of those not biopsied. PPI use at time of biopsy was negatively associated with EoE diagnosis (odds ratio: 0.39, confidence interval: 0.17–0.85). Sixty-one (37.4%) patients were lost to follow-up at 6 months. Recurrent EFI at 1 year occurred in 3.7% of patients. Medications, most commonly PPI, are frequently prescribed after EFI when the endoscopic features of EoE are present, which may mask the diagnosis of EoE on follow-up EGD. We estimated that for every five patients biopsied on PPI, one case of EoE is masked. As recurrent EFI within 1 year is uncommon, empiric therapy should be avoided until diagnostic biopsies are obtained. Further efforts to reduce loss to follow-up after EFI are also needed.

Case report of severe iron deficiency anemia caused by proton pump inhibitor in an elderly patient

2017 ◽  
Vol 17 (4) ◽  
pp. 662-663 ◽  
Author(s):  
Suguru Mabuchi ◽  
Risa Suzuki ◽  
Mari Sasaki ◽  
Marie Nakamura ◽  
Norihiko Izumimoto ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Iron Deficiency ◽  
Proton Pump Inhibitor ◽  
Iron Deficiency Anemia ◽  
Proton Pump ◽  
Deficiency Anemia

scholarly journals The First Asian Case Report of Eosinophilic Esophagitis in an Asymptomatic Adult: What About a Proton Pump Inhibitor Trial?

2009 ◽  
Vol 72 (3) ◽  
pp. 166-167 ◽  
Author(s):  
Javier Molina-Infante ◽  
Moises Hernandez-Alonso ◽  
Belen Perez-Gallardo ◽  
Elisa Martin-Noguerol
Keyword(s):  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Asymptomatic Adult

scholarly journals Prevalence of gastric polypoid lesions in a single endoscopic centre

2013 ◽  
Vol 154 (20) ◽  
pp. 770-774
Author(s):  
Ágnes Anna Csontos ◽  
Bálint Fekete ◽  
Katalin Lőrinczy ◽  
Orsolya Terjék ◽  
Lajos Berczi ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Chronic Gastritis ◽  
Malignant Lesion ◽  
Fundic Gland ◽  
Hyperplastic Polyps ◽  
Gastric Polyps ◽  
Fundic Gland Polyps ◽  
Upper Gastrointestinal

Background: The prevalence of gastric polyps is unknown in Hungary. Aim: The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. Methods: Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. Results: 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). Conclusions: The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively. Orv. Hetil., 2013, 154, 770–774.

scholarly journals GASTRIC FUNDIC GLAND POLYPS: CAN HISTOLOGY BE USEFUL TO PREDICT PROTON PUMP INHIBITORS USE?

2018 ◽  
Vol 55 (4) ◽  
pp. 380-384
Author(s):  
Hugo Leite de Farias BRITO ◽  
Cynthia BARROS ◽  
Marcelle Vieira FREIRE ◽  
Miraldo Nascimento da SILVA FILHO ◽  
Tereza Virgínia NASCIMENTO
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump Inhibitors ◽  
Parietal Cell ◽  
Proton Pump ◽  
Proton Pump Inhibitor Therapy ◽  
Inhibitor Therapy ◽  
Fundic Gland ◽  
Acid Therapy ◽  
Fundic Gland Polyps ◽  
Two Samples

ABSTRACT BACKGROUND: Fundic gland polyps allegedly increased in frequency in recent decades, and had attracted great attention due to possible association with prolonged proton pump inhibitor therapy. Prolonged use of this drug could cause parietal cell hyperplasia, obstruction of glandular lumen and cystic dilation of the gland. OBJECTIVE: This study aims to analyze clinical and pathological features of fundic gland polyps in patients with and without proton pump inhibitor therapy in a selected population from Brazil. METHODS: It was selected a sample of 101 Brazilian patients (78 females and 23 males), from a five years retrospective search of the files from a private pathology laboratory. The patients had an average age of 57 years and we included patients with a histological diagnosis of fundic gland polyp. The clinical data were obtained from their files and all histological slides were reviewed and examined with hematoxylin and eosin (HE) and Giemsa. RESULTS: Information about the use or non-use of proton pump inhibitors (PPI) was obtained in 84 patient files. In 17 cases we could not determine if PPI were used or not. Among those in which the information was available, a positive history of anti-acid therapy was observed in 63 (75.0%) patients. Parietal cell hypertrophy/hyperplasia and parietal cell protrusions were detected in most slides. Histological findings were identical in PPI users and PPI negative patients. Helicobacter pylori infection was detected in just two samples. Epithelial dysplasia or adenocarcinoma were not observed in our cases. Histopathological analysis of fundic gland polyps could not distinguish between PPI and non-PPI related cases. Parietal cell cytoplasmic protrusions, an alleged marker of prolonged acid suppression therapy, was detected in both groups. CONCLUSION: Histological features could not discriminate anti-acid therapy related fundic glands polyps in our patients.

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