Sato Yuki, Takenaka Ryuta, Matsumi Akihiro, Takei Kensuke, Okanoue Shotaro, Yasutomi Eriko, Kawai Daisuke, Takemoto Koji, Tsugeno Hirofumi, Miyake Takayoshi, Fujiki Shigeatsu
Department of Internal Medicine, Tsuyama Chuo Hospital, Japan.
Department of Clinical Laboratory, Pathology Division, Tsuyama Chuo Hospital, Japan.
Intern Med. 2018 Jan 1;57(1):25-29. doi: 10.2169/internalmedicine.8668-16. Epub 2017 Oct 11.
Esophageal lichen planus (ELP) is rare and only about 80 cases have been reported in the literature. An 85-year-old woman presented with dysphagia and odynophagia. Endoscopy revealed a severe stricture in the proximal esophagus. Oral examinations at two years after the first endoscopy revealed erosions around the gingiva, and an examination of biopsy specimens taken from the site of erosion led to a diagnosis of oral lichen planus. Esophageal endoscopy was performed again, and biopsy specimens showed spongiosis and necrotic keratinocytes in the epithelium (civatte bodies). The patient was diagnosed with ELP and was treated with systemic corticosteroids, which resulted in clinical relief.
食管扁平苔藓（ELP）较为罕见，文献中仅报道了约80例。一名85岁女性出现吞咽困难和吞咽痛。内镜检查发现食管近端严重狭窄。首次内镜检查两年后的口腔检查发现牙龈周围有糜烂，对糜烂部位采集的活检标本进行检查后诊断为口腔扁平苔藓。再次进行食管内镜检查，活检标本显示上皮出现海绵形成和坏死角质形成细胞（西瓦特小体）。该患者被诊断为ELP，并接受了全身糖皮质激素治疗，临床症状得到缓解。
