Abnormalities of differentiation and maturation in the oesophageal squamous epithelium of patients with tylosis: morphological features.
Tylosis is an autosomal dominant inherited defect of keratinization, associated in two Liverpool families with a high risk of developing oesophageal squamous carcinoma. In 29 individuals, followed by regular endoscopy and biopsy, we have noted several morphological abnormalities of the epithelium in this pre-cancerous condition. A control group of 43 non-tylotic patients with normal oesophageal histology and a further 26 patients with acute oesophagitis was used for comparison. Recognizable dysplasia was confined to the older age range in the tylotic group and was present in four patients. Almost half of the patients showed acute inflammation. Abnormalities of maturation were common, the most frequent being the presence of prominent basophilic inclusions and clear cell acanthosis, with parakeratosis and frank surface keratinization present in smaller numbers. There was, however, no statistically significant difference between the tylotic and inflamed control groups for any of these features. The only feature to show a significant difference between these groups was the presence of individual cell keratinization. The results suggest that in the oesophageal epithelium of the patients with tylosis, inflammation is the predominant abnormality, together with individual cell keratinization, and that these lesions appear in a much younger age group than dysplasia.
University Department of Pathology, Liverpool, UK.
M T
MT
Ashworth
J R
JR
Nash
A
A
Ellis
D W
DW
Day
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000473:pathology*; D002454:Cell Differentiation; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D004938:Esophageal Neoplasms / Q000209:etiology / Q000473:pathology*; D004941:Esophagitis / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D015776:Keratoderma, Palmoplantar, Diffuse / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged