Can heterotopic gastric mucosa present as globus pharyngeus?

2006 ◽  
Vol 120 (7) ◽  
pp. 575-578 ◽  
Author(s):  
J L Lancaster ◽  
S Gosh ◽  
R Sethi ◽  
S Tripathi
Keyword(s):  
Gastric Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Gastric Epithelium ◽  
Anatomical Site ◽  
Small Areas ◽  
Globus Pharyngeus ◽  
Number Of Factors ◽  
Gastric Type ◽  
High Incidence ◽  
History Of

We present a series of four patients presenting with symptoms leading to a provisional diagnosis of globus pharyngeus. On further investigation, they were all found to have small areas of abnormal mucosa in either their hypopharynx or proximal oesophagus, which on biopsy were reported as containing gastric-type mucosa. Following anti-reflux treatment, all patients eventually reported a cessation of symptoms. All but one patient was followed up with repeat endoscopies. We highlight the fact that biopsies reporting gastric epithelium at this anatomical site are in keeping with the diagnosis of heterotopic gastric mucosa. We review the literature and report the high incidence and natural history of this condition.Heterotopic gastric mucosa can only be diagnosed on endoscopy and is easily missed, even during such an investigation. We raise the question of whether this condition may be one of a number of factors in the aetiology of globus pharyngeus.

scholarly journals Symptomatic Heterotopic Gastric Mucosa in Distal Esophagus

2021 ◽  
Author(s):  
Avnish Kumar Seth ◽  
Mahesh Kumar Gupta ◽  
Gursimran Kaur ◽  
Priti Jain ◽  
Rinkesh Kumar Bansal
Keyword(s):  
Gastric Mucosa ◽  
Squamous Epithelium ◽  
Narrow Band Imaging ◽  
Distal Esophagus ◽  
Heterotopic Gastric Mucosa ◽  
Retrosternal Pain ◽  
Gastric Type ◽  
History Of ◽  
Mass Lesions

Abstract Introduction Heterotopic gastric mucosa (HGM) in esophagus is commonly noted as an inlet patch at endoscopy. We describe a rare patient with symptomatic distal esophageal HGM. Case Report A 40-year-old male presented with retrosternal pain and marked odynophagia for the last 4 weeks without any history of ingestion of antibiotics, foreign body, or corrosive. Endoscopy showed abrupt circumferential transition to salmon pink mucosa at 35 cm from incisors. From 35 to 41 cm, there were areas of polypoid edematous thickening with few superficial ulcers of 1 to 3 mm. Squamous epithelium was visualized at narrow band imaging from 41 cm to the Z-line at 43 cm with no hiatus hernia. Biopsy showed gastric-type mucosa with parietal cells without dysplasia. Serology for cytomegalovirus and human immunodeficiency virus was negative. He was managed with proton pump inhibitors (PPIs) and prokinetics and improved symptomatically. Follow-up endoscopy at 3 months demonstrated healing of ulcers with persistence of HGM and pseudopolyps. He remains well on maintenance with PPI at 1-year follow-up. Conclusion Symptomatic HGM in distal esophagus is rare and can be differentiated from Barrett’s esophagus histologically and by presence of squamous epithelium between HGM and stomach. Inflammatory mass lesions may develop and mimic esophageal malignancy. Symptoms are largely due to acid production and usually respond to PPI.

scholarly journals Unusual case of adult familial Menetrier disease in siblings

2019 ◽  
Vol 12 (10) ◽  
pp. e231175
Author(s):  
Emily Brownson ◽  
Adrian J Stanley ◽  
Prakash Konanahalli ◽  
John P Seenan
Keyword(s):  
Family History ◽  
Iron Deficiency ◽  
Gastric Mucosa ◽  
Iron Deficiency Anaemia ◽  
Unusual Case ◽  
Gastric Epithelium ◽  
Deficiency Anaemia ◽  
History Of ◽  
Mucosal Folds ◽  
Gastric Malignancy

Menetrier disease is a rare disease characterised by hyperplasia of the gastric epithelium and large gastric folds. We present a case of a 58-year-old woman who was referred with iron deficiency anaemia, with a family history of a sibling who had undergone gastrectomy for presumed gastric malignancy. Endoscopy showed prominent gastric mucosal folds and biopsies showed hyperplastic gastric mucosa, with prominent foveolar hyperplasia suggestive of Menetrier disease. Further information about her brother’s diagnosis was sought, and it was found that his pathology after gastrectomy showed diffuse glandular hyperplasia also in keeping with Menetrier disease. Adult familial Menetrier disease has so far been a rarity in the literature—review elicits five previous cases of this presentation in siblings.

scholarly journals Duodenal Bulb Mucosa with Hypertrophic Gastric Oxyntic Heterotopia in Patients with Zollinger Ellison Syndrome

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Emil Kohan ◽  
David Oh ◽  
Hank Wang ◽  
Salar Hazany ◽  
Gordon Ohning ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Gastric Acid ◽  
Duodenal Bulb ◽  
Duodenal Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Blue Staining ◽  
Surface Epithelium ◽  
The Novel ◽  
Zollinger Ellison Syndrome ◽  
Gastric Type

Objectives. Zollinger-Ellison Syndrome (ZES) results in hypersecretion of gastric acid (via gastrinoma) leading to peptic ulcers, diarrhea, and abdominal pain. We describe the novel discovery of hypertrophic, heterotopic gastric mucosa in the proximal duodenal bulb in patients with ZES, which we hypothesize results in an increased incidence of postbulbar ulcers in patients with ZES (a mechanism previously unreported). We determined the incidence of the novel finding of duodenal gastric oxyntic hypertrophic heterotopia (GOH) in patients with ZES. Methods. Seven patients with ZES were enrolled. The diagnosis of ZES was established by hypergastrinemia, gastric acid hypersecretion, and a positive secretin test or based on biopsy specimens (evaluated via tissue staining). Basal acid output (BAO) and baseline gastrin secretion were determined by established methods. Endoscopic examinations with methylene blue staining and biopsy of the gastric and duodenal mucosa were conducted in all patients every 3–6 months for an average of 5 years. Results. The duodenal mucosa demonstrated hypertrophic GOH in 5 out of 7 patients with ZES and an intact stomach and duodenum. Biopsies from the bowel mucosa demonstrated patchy replacement of surface epithelium by gastric-type epithelium with hypertrophic oxyntic glands in the lamina propria in 5 patients. Two of the patients had no evidence of GOH in the duodenal bulb. Patients with GOH had an average serum gastrin level of 1245 pg/mL and BAO of 2.92 mEq/hr versus 724 pg/mL and 0.8 mEq/hr in patients without GOH. Conclusions. This study demonstrated the presence of duodenal mucosa with GOH in 5 out of 7 patients with ZES and an intact stomach and duodenum. The presence of hypertrophic and heterotopic gastric mucosa is proposed to result from increased gastrin levels and may contribute to the increased incidence of postbulbar ulcers in these patients.

scholarly journals Diagnostic Value of Endoscopic and Endoscopic Ultrasound Characteristics of Duodenal Submucosal Tumour-Like Heterotopic Gastric Mucosa

2011 ◽  
Vol 25 (7) ◽  
pp. 365-367 ◽  
Author(s):  
Koichi Eguchi ◽  
Kunihiko Aoyagi ◽  
Satoshi Nimura ◽  
Shotaro Sakisaka
Keyword(s):  
Gastric Mucosa ◽  
Endoscopic Ultrasound ◽  
Diagnostic Value ◽  
Heterotopic Gastric Mucosa ◽  
Pathological Examination ◽  
Endoscopic Polypectomy ◽  
Diagnostic Features ◽  
Gastric Glands ◽  
Gastric Type ◽  
Duodenal Epithelium

OBJECTIVE: Recent studies have reported that duodenal heterotopic gastric mucosa (HGM) has been observed in 8.9% of patients who undergo esophagogastroduodenoscopy. However, there are few reports concerning the endoscopic and endoscopic ultrasound characteristics of submucosal tumour-like HGM in the duodenum.METHODS: Endoscopic, endoscopic ultrasound (EUS) and histological findings were analyzed in six patients with submucosal tumour-like HGM, which were confirmed by pathological examination of biopsy or endoscopic polypectomy specimens.RESULTS: Endoscopically, the lesions appeared as a solitary, sessile submucosal tumour-like mass with a depression at the top. In four of six patients, small granular structures were found in the depressed area of the mass. On EUS, all masses demonstrated a heterogeneous pattern, among which four patients presented anechoic areas while two patients showed no anechoic areas. All lesions were localized within the mucosa and submucosa on EUS. Histologically, they consisted of gastric glands and some dilated glands, and were covered with normal duodenal epithelium. In four of six lesions, the tumours were composed of gastric-type foveolar epithelium showing papillary growth, fundic glands and pyloric glands, while the others consisted of gastric-type foveolar epithelium and pyloric glands.CONCLUSION: A heterogeneous pattern on EUS and small granular structures on esophagogastroduodenoscopy represent valuable diagnostic features of submucosal tumour-like HGM.

’Pyloric gland-type adenoma' arising in heterotopic gastric mucosa of the duodenum, with dysplastic progression of the gastric type

1999 ◽  
Vol 435 (4) ◽  
pp. 452-457 ◽  
Author(s):  
R. Kushima ◽  
H. J. Rüthlein ◽  
M. Stolte ◽  
M. Bamba ◽  
T. Hattori ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Pyloric Gland ◽  
Gastric Type ◽  
Gland Type

scholarly journals Prevalence of barrett's esophagus, its relationship with chronic Helicobacter pylori-associated gastritis, atrophy and metaplasia of gastric mucosa

2019 ◽  
Vol 2 (8) ◽  
pp. 77-89
Author(s):  
T.V. Serha ◽  
O.G. Kuryk ◽  
V.A. Yakovenko ◽  
G.A. Solovyova ◽  
R.P. Tkachenko
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Intestinal Metaplasia ◽  
Barrett’S Esophagus ◽  
Histological Examination ◽  
Barrett's Esophagus ◽  
Gastric Epithelium ◽  
Gastric Type ◽  
H Pylori ◽  
Epithelial Metaplasia

The aim - to identify the frequency of Helicobacter pylori infection, atrophic and metaplastic changes in the gastric mucosa in patients with Barrett's esophagus. Materials and methods. A retrospective study of 7392 cases of complex esophagogastroscopy with a biopsy of the epithelium of the mucous membrane of the esophagus and stomach, followed by a morphological study, was conducted on the basis of the Medical Centre “Oberig” clinic for the period 2010-2018. Statistical data was performed using the MedStat package. To assess the prevalence of changes in the esophagus and stomach, a 95% confidence interval was calculated using the Fisher angular transformation method. The probability of differences between group averages and relative values ​​was determined using the method of parametric statistics by calculating the t-Student criterion. The difference between the average values ​​was considered significant at p <0.05. To compare the frequencies in different groups, the Pearson chi-square test was used. Results. Endoscopically cylindrical columnar metaplasia of the esophagus epithelium was detected in 2994 patients (40.5% CI 39.4% -41.6% at a significance level of p = 0.05). In a histological examination, esophageal epithelial metaplasia was confirmed in 2910 patients (39.4% CI 38.3%-40.5%). 876 cases of gastric-type esophagus epithelial metaplasia were diagnosed (30.1%, CI 28.4-31.5%); 2034 cases of intestinal type metaplasia (69.9%, CI 68.2-71.6%). Histological examination of biopsy samples of the gastric mucosa in 5640 (76.3%, CI 75.3-77.3%) patients revealed atrophy of the gastric mucosa. In 2532 cases (34.3%, CI 33.2-35.3%), complete and incomplete intestinal metaplasia of the gastric epithelium was diagnosed. In 4524 (61.2%, CI 60.1-62.3%) patients, Helicobacter pylori was detected. In the presence of H. pylori, gastric esophageal epithelial metaplasia was detected in 510 of 3558 (14.3%, CI 13.2-15.5%, p = 0.05), intestinal metaplasia of the esophagus epithelium - in 966 of 4014 (24.1% CI 22.8 -25.4%, p = 0.05). Conclusion. Esophageal epithelial metaplasia is a common pathology, accounting for 39.4% among patients who underwent esophagogastroscopy. The presence of a strong connection between intestinal metaplasia of the epithelium of the esophagus and atrophy of the gastric mucosa with intestinal metaplasia of the epithelium of the stomach was found. Esophageal epithelial metaplasia is significantly less common with Helicobacter pylori gastritis, therefore the presence of H. pylori has a protective effect on the occurrence of esophageal epithelial metaplasia.

A new approach to the logic of discovery

2007 ◽  
Vol 50 (1) ◽  
pp. 7-27
Author(s):  
Gerald Massey
Keyword(s):  
Modal Logic ◽  
Scientific Discovery ◽  
Traditional View ◽  
New Approach ◽  
Logic Of Discovery ◽  
Good Fortune ◽  
High Incidence ◽  
History Of ◽  
Deep Sense

Contending that the quest for a logic of scientific discovery was prematurely abandoned, the author lays down eight phenomena that such a logic or theory must explain: the banality of scientific discovery; the trainability of scientists; the high incidence of simultaneous discoveries; the ubiquity of relative novices; the fact of scientific genius; the barrenness of isolated workers; the incommensurability of concepts of successive theories; and the quasi-incorporation of old concepts, objects, and methods in successor theories, The author then presents a new theory or logic of discovery according to which discoveries are the termini of "tweak paths" generated when scientists "tinker" with the laws, concepts, methods, and instruments of a given theory. Tinkering and tweaking are illustrated by examples from many-valued and modal logic and from Darwinian biology. Through the history of planetary discovery, the accidental role played by luck or good fortune in some discoveries is explored, but the author emphasizes that in a deep sense serendipity is an in eliminable feature of all scientific discovery because scientists never know m advance whether their tweaks will lead to dead ends or to positive developments. The author's new theory of scientific discovery is shown to account for all eight explananda, ft also reveals science to be a more egalitarian enterprise than the traditional view of scientific discovery as ultimately inexplicable depicts it.

scholarly journals Acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) associated with choroidal melanoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aluisio Rosa Gameiro Filho ◽  
Guilherme Sturzeneker ◽  
Ever Ernesto Caso Rodriguez ◽  
André Maia ◽  
Melina Correia Morales ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Serous Retinal Detachment ◽  
Central Nervous System Involvement ◽  
Choroidal Melanoma ◽  
Posterior Pole ◽  
Pancreatic Metastasis ◽  
Small Areas ◽  
History Of ◽  
The Right

Abstract Background To report a case of acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with a history of choroidal melanoma, with metastases to the pancreas, liver, and central nervous system. Case presentation A 63-year-old patient, with a history of enucleation of the right eye due to choroidal melanoma, complained of progressive visual loss during a follow-up visit. Fundoscopic examination revealed multiple small areas of serous retinal detachment scattered throughout the posterior pole and ancillary tests confirmed the diagnosis of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM). Screening for systemic metastases showed pancreatic, hepatic, and central nervous system involvement. Conclusions We describe a rare case of acute exudative polymorphous paraneoplastic vitelliform maculopathy, which should be considered in patients with or without a history of melanoma, who have vitelliform retinal detachments. Nevertheless, no previous reviews of literature have shown a correlation between AEPPVM and pancreatic metastasis.

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