PMC5646309_01
Stricture in the lower third of esophagus.
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She underwent multiple esophagogastroduodenoscopies (EGD) with findings of mucosal friability, webs, and strictures (Figures 1-3).
Stricture in the middle third of esophagus.
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fig2
She underwent multiple esophagogastroduodenoscopies (EGD) with findings of mucosal friability, webs, and strictures (Figures 1-3).
Proximal stricture treated with dilatation.
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fig3
She underwent multiple esophagogastroduodenoscopies (EGD) with findings of mucosal friability, webs, and strictures (Figures 1-3).
Esophageal squamous epithelium with H&E staining at 100x magnification. Findings showing lymphocytic infiltrate in the basal layer and scattered apoptotic keratinocytes (Civatte bodies).
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fig4
Seven years after her initial presentation, deep esophageal biopsy specimens were obtained showing severe acute and chronic esophagitis with a lichenoid-like pattern of chronic inflammation with notable features of lymphocytic infiltrate involving the basal layer of the epithelium and scattered apoptotic keratinocytes (Civatte bodies) (Figures 4 and 5) raising strong consideration of ELP.
Esophageal squamous epithelium with H&E staining at 200x magnification with black arrow showing a Civatte body.
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fig5
Seven years after her initial presentation, deep esophageal biopsy specimens were obtained showing severe acute and chronic esophagitis with a lichenoid-like pattern of chronic inflammation with notable features of lymphocytic infiltrate involving the basal layer of the epithelium and scattered apoptotic keratinocytes (Civatte bodies) (Figures 4 and 5) raising strong consideration of ELP.
Esophageal mucosal tear after dilatation procedure occurring late in the patient's course highlighting the potential increased risk of complications with further endoscopic interventions.
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fig6
By this time, her symptoms had already become severely debilitating with worsening strictures and narrowing throughout the esophagus, carrying a substantial risk for perforation with continued dilations (Figure 6).