title: Eosinophilic esophageal myositis diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report.
abstract: Eosinophilic esophagitis (EoE) is diagnosed by microscopic findings of eosinophilic infiltration into the squamous epithelium. In contrast, another disease concept termed "eosinophilic esophageal myositis (EoEM)" has been proposed, whereby there is eosinophilic infiltration into the muscularis propria instead. A 60-year-old man was referred to our hospital for chest pain, dysphagia, and several episodes of esophageal food impaction. Although EoE was suspected based on clinical features, biopsy specimens showed no mucosal eosinophilic infiltration. Endoscopic ultrasound (EUS) showed thickening of the muscularis propria layer and subsequent EUS-guided fine-needle aspiration biopsy (EUS-FNA) revealed eosinophilic infiltration into the muscularis propria. Although the patient's symptoms gradually improved after steroid administration, complete remission was not achieved after 1 year of treatment. This case may reflect a disorder distinct from typical EoE based on eosinophilic infiltration of the muscularis propria but not the squamous epithelium, and we, therefore, diagnosed it as EoEM using the EUS-FNA findings as reference.
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan. ryo-i@fmu.ac.jp.
authors: Ryo
authors: R
authors: Igarashi
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Atsushi
authors: A
authors: Irisawa
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Goro
authors: G
authors: Shibukawa
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Akane
authors: A
authors: Yamabe
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Mariko
authors: M
authors: Fujisawa
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Ai
authors: A
authors: Sato
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Takumi
authors: T
authors: Maki
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Noriyuki
authors: N
authors: Arakawa
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Yoshitsugu
authors: Y
authors: Yoshida
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Shogo
authors: S
authors: Yamamoto
authors: Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2, Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, 969-3492, Japan.
authors: Tsunehiko
authors: T
authors: Ikeda
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
keywords: EUS; EUS-FNA; Eosinophilic esophageal myositis; Eosinophilic esophagitis