Update on esophagitis: controversial and underdiagnosed causes.
BACKGROUND
Esophagitis is a common cause of symptoms for which patients seek the advice of a physician. Esophagitis of differing etiologies often demonstrate overlapping histopathologic features, making their distinction difficult. This is especially true in esophageal disorders associated with increased numbers of intraepithelial eosinophils, some of which have just recently been recognized.


OBJECTIVE
This review discusses the important clinical and pathologic features of the 2 most common disorders associated with esophageal eosinophilic infiltrates--reflux esophagitis and eosinophilic esophagitis--with special emphasis on features that allow the surgical pathologist to distinguish between these disorders. The various forms of drug-induced esophagitis are also discussed because these are frequently underrecognized by pathologists.


METHODS
Data were extracted from articles identified through PubMed-based research. Histologic figures have been taken from the personal case collection of the author.


CONCLUSIONS
Reflux and eosinophilic esophagitis demonstrate overlapping histologic features, which may make their distinction difficult. Drug-induced esophagitis is probably a common phenomenon but is underrecognized by pathologists.
Noffsinger
Amy E
AE
Department of Pathology, University of Chicago Medical Center, Chicago, Illinois 60637, USA. amy.noffsinger@uchospitals.edu
D000328:Adult; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000175:diagnosis; D064420:Drug-Related Side Effects and Adverse Reactions; D004804:Eosinophils / Q000473:pathology; D004941:Esophagitis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology*; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006801:Humans