title: Value of an Additional Review for Eosinophil Quantification in Esophageal Biopsies.
abstract: Eosinophilic esophagitis (EoE) requires a peak count of 15 eosinophils per high-power field (hpf). Herein, the peak eosinophil count specified by a pathologist was compared with the second review of a research assistant. Of 477 biopsies, 106 had a peak count between 1 and 14 eosinophils/hpf cited in the pathology report, and 23/106 (22%) had ≥15 eosinophils/hpf on second review. The pathology report detected potential EoE with 99% specificity, but 80% sensitivity. As such, an additional review of esophageal biopsies yields higher eosinophil counts in ∼5% of cases. We propose that biopsies with a count between 1 and 14 eosinophils/hpf require further investigation because ∼22% may yield a potential EoE diagnosis.
authors: *Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center †Department of Pediatrics, University of Cincinnati College of Medicine ‡Division of Pathology and Laboratory Medicine §Division of Human Genetics ||Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Emily M
authors: EM
authors: Stucke
authors: Katherine E
authors: KE
authors: Clarridge
authors: Margaret H
authors: MH
authors: Collins
authors: Carol J
authors: CJ
authors: Henderson
authors: Lisa J
authors: LJ
authors: Martin
authors: Marc E
authors: ME
authors: Rothenberg
mesh_terms: D001706:Biopsy; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000473:pathology; D004804:Eosinophils / Q000473:pathology*; D004947:Esophagus / Q000473:pathology*; D006801:Humans; D007958:Leukocyte Count; D015588:Observer Variation; D012016:Reference Values
references: Mod Pathol. 2006 Jan;19(1):90-6
references: 16258505
references: Am J Gastroenterol. 2007 Oct;102(10):2300-13
references: 17617209
references: Gastroenterology. 2007 Oct;133(4):1342-63
references: 17919504
references: Am J Gastroenterol. 2009 Feb;104(2):485-90
references: 19174804
references: Dig Dis Sci. 2010 Jul;55(7):1940-9
references: 19830560
references: Am J Gastroenterol. 2011 May;106(5):824-32; quiz 833
references: 21304500
references: J Allergy Clin Immunol. 2011 Jul;128(1):3-20.e6; quiz 21-2
references: 21477849