ASGE Recognized Industry Associate (ARIA) Training Program for Regeneron and Sanofi | June 2023-Pathologists Perspective of EoE

Pdf Summary

In this document, the focus is on the pathologist's perspective of Eosinophilic Esophagitis (EoE). The objectives of this curriculum include outlining the differential diagnoses of intraepithelial eosinophilia, characterizing the histologic criteria of EoE, and discussing clinical findings that help in distinguishing and reaching a diagnosis of EoE.<br /><br />The document mentions that pathologists play a crucial role in diagnosing EoE through histologic assessment. Hematoxylin and Eosin (H&E) staining is commonly used to visualize the microscopic features of the esophageal tissue. Normal esophageal histology is also described, including the layers of the esophagus and typical findings in a normal esophageal mucosal biopsy.<br /><br />The causes, risk factors, and associations of esophageal eosinophilia are discussed, including genetics and environmental allergens. The diagnostic criteria for EoE are outlined, with a focus on both clinical and pathological factors. The histologic features of EoE are described, including inflammatory cells in the epithelium, basal cell hyperplasia, elongation of the lamina propria papillae, vascular dilation, and spongiosis.<br /><br />The document also highlights the challenges in diagnosing EoE, such as limited correlation with symptoms, heterogeneity in quantification methods, and tissue sampling variability. The distinction between EoE and reflux esophagitis is explored, including the microscopic features and clinical differences between the two conditions.<br /><br />Finally, the document offers diagnostic tips and pearls for pathologists, emphasizing the importance of considering all features present or absent, obtaining endoscopic findings and clinical history, and conducting multiple biopsies for higher diagnostic sensitivity.<br /><br />Overall, this document provides a comprehensive overview of EoE from the pathologist's perspective, including the diagnostic criteria, histologic features, and challenges in diagnosing the condition.

Asset Subtitle

Safia N. Salaria, MD, MMHCM.D., MMHC

Keywords

pathologist's perspective

Eosinophilic Esophagitis

differential diagnoses

histologic criteria

clinical findings

diagnosing EoE

normal esophageal histology

esophageal eosinophilia

diagnostic criteria

challenges in diagnosing EoE