Ishoo Edwin, Busaba Nicolas Y
Division of Otolaryngology-Head and Neck Surgery, Carle Clinic Association, Urbana, IL, USA.
Am J Otolaryngol. 2002 May-Jun;23(3):181-4. doi: 10.1053/ajot.2002.123437.
This study describes the clinical presentation and management of ectopic gastric mucosa (EGM) in the cervical esophagus. This is a case report of a 53-year-old male who presented with left-sided odynophagia of 3 months' duration. Office examination, including flexible fiberoptic laryngoscopy, was unremarkable. Direct larynogoscopy and rigid esophagoscopy revealed a 2 x 1-cm fleshy, red, and raised lesion in the cervical esophagus. The remainder of the esophagus was normal. Histologic examination of a biopsy specimen from the lesion showed a normal gastric epithelium consistent with the diagnosis of ectopic gastric mucosa. He was treated with 3 months of proton pump inhibitors, which resulted in complete symptom resolution. Patient was then switched to H2-blockers and has been symptom-free for one year. The medical literature regarding EGM in the cervical esophagus is reviewed with respect to its incidence, pathogenesis, clinical course, and management. In conclusion, EGM can occur in the cervical esophagus, and odynophagia is the typical presenting symptom. Adenocarcinoma developing within random, nonsyndromic EGM of the cervical esophagus is exceedingly rare. The primary mode of treatment is medical therapy.
本研究描述了颈段食管异位胃黏膜（EGM）的临床表现及治疗方法。这是一例53岁男性患者的病例报告，该患者左侧吞咽痛持续3个月。包括纤维喉镜检查在内的门诊检查未见异常。直接喉镜检查和硬式食管镜检查发现颈段食管有一个2×1厘米大小的肉质、红色隆起病变。食管其余部分正常。病变活检标本的组织学检查显示为正常胃上皮，符合异位胃黏膜的诊断。他接受了3个月的质子泵抑制剂治疗，症状完全缓解。随后患者改用H2受体阻滞剂，至今已无症状一年。本文就颈段食管EGM的发病率、发病机制、临床病程及治疗方法对医学文献进行了综述。总之，EGM可发生于颈段食管，吞咽痛是典型的临床表现。颈段食管随机、非综合征性EGM内发生腺癌极为罕见。主要治疗方式为药物治疗。
