Lucendo Alfredo J, De Rezende Livia, Martín-Plaza Jesús, Larrauri Javier
Department of Gastroenterology, Hospital Universitario La Paz, Madrid, Spain.
Case Rep Gastroenterol. 2008 Feb 5;2(1):33-9. doi: 10.1159/000113220.
We illustrate the case of a 41-year-old male with allergic manifestations since childhood. He sought medical attention for intermittent, progressive dysphagia from which he had been suffering for a number of years, having felt the sensation of a retrosternal lump and a self-limited obstruction to the passage of food. Endoscopy detected a submucosal tumor in the upper third of the esophagus, which was typified, via biopsy, as a granular cell tumor with benign characteristics and probably responsible for the symptoms. Two years later, the patient sought medical attention once again as these symptoms had not abated, hence digestive endoscopy was repeated. This revealed stenosis of the junction between the middle and lower thirds of the organ which had not been detected previously but was passable under gentle pressure. Eosinophilic esophagitis was detected after biopsies were taken. Esophageal manometry identified a motor disorder affecting the esophageal body. Following three months of treatment using fluticasone propionate applied topically, the symptoms went into remission, esophageal stenosis disappeared and the esophageal biopsies returned to normal. This is the first documented case of the link between granular cell tumors and Eosinophilic esophagitis, two different disorders which could cause dysphagia in young patients.
我们举例说明一名41岁男性的病例，他自童年起就有过敏表现。他因间歇性、进行性吞咽困难多年来一直寻求医疗帮助，有胸骨后肿块的感觉以及食物通过时的自限性梗阻感。内镜检查在食管上三分之一处发现一个黏膜下肿瘤，经活检确定为具有良性特征的颗粒细胞瘤，可能是导致这些症状的原因。两年后，由于这些症状没有减轻，患者再次寻求医疗帮助，因此再次进行了消化内镜检查。检查发现食管中下段交界处狭窄，之前未被检测到，但在轻柔压力下可通过。活检后检测出嗜酸性食管炎。食管测压发现食管体部存在运动障碍。在局部应用丙酸氟替卡松治疗三个月后，症状缓解，食管狭窄消失，食管活检恢复正常。这是颗粒细胞瘤与嗜酸性食管炎之间关联的首例有记录病例，这两种不同的疾病都可能导致年轻患者出现吞咽困难。
