title: A case of black esophagus with histopathologic description and characterization.
abstract: Black esophagus, or acute necrotizing esophagitis, is a blackening of the esophagus that is usually distal with a sharp demarcation at the gastroesophageal border. Black esophagus is known to the gastroenterology community; however, to our knowledge it is virtually unknown in the pathology literature with only a single instance described in 1967. It is thought to occur as a poorly elucidated ischemic phenomenon. We report a case of black esophagus in a 45-year-old woman with a history of cocaine and alcohol abuse who was found unresponsive after a vague 2-day illness. On autopsy examination, the esophagus was black with ischemic necrosis of the mucosa, submucosa, and muscularis propria including a diffuse acute inflammatory infiltrate and brown pigmentation limited to the mucosa. Positive periodic acid-Schiff and negative iron stains suggest that the pigment is lipofuscin, likely secondary to ischemia.
authors.affiliation: Department of Pathology, Orlando Regional Healthcare, Florida 32806, USA. dlaltenb@neoucom.edu
authors.forename: Dana L
authors.initials: DL
authors.lastname: Altenburger
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Wagner
authors.forename: Shuan
authors.initials: S
authors.lastname: Li
authors.forename: Jan
authors.initials: J
authors.lastname: Garavaglia
mesh_terms: D000208:Acute Disease; D004941:Esophagitis / Q000150:complications / Q000175:diagnosis*; D004947:Esophagus / Q000098:blood supply / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D009336:Necrosis; D019966:Substance-Related Disorders