Jessurun J, Yardley J H, Giardiello F M, Hamilton S R
Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, Maryland.
Mod Pathol. 1988 May;1(3):175-81.
Esophageal mucosal biopsy specimens frequently show numerous distended squamous cells with pale cytoplasm, which we term "balloon cells." These cells often occur in clusters, have a patchy distribution, and predominate in the prickle-cell layer in biopsies from patients with gastroesophageal reflux. We studied the immunohistochemical characteristics of balloon cells and their associated clinical findings. We demonstrated by immunoperoxidase technique that balloon cells contain intracytoplasmic albumin and immunoglobulin light chains and show reduced staining for keratin, suggesting cellular injury with resultant uptake of plasma proteins and fluid. Balloon cells were absent or sparse in esophageal mucosal biopsy specimens from 12 normal control persons, but were observed in 7 of 10 patients (70%) with gastroesophageal reflux confirmed by pH-probe test (P = 0.001 versus normal controls), in 16 of 25 patients (64%) with clinically suspected reflux (P less than 0.001), and in 4 of 5 patients with infectious or chemotherapy-associated esophagitis. However, no consistent association was found between balloon cells and the presence of the usual histopathologic criteria for epithelial injury, such as increased height of vascular tufts or width of basal zone. We conclude that balloon cells are most commonly observed in biopsy specimens from patients with various causes of esophageal injury. We propose that balloon cells may be a marker for epithelial injury, possibly even when other histopathologic criteria for injury are absent.
食管黏膜活检标本经常显示出许多细胞质苍白的扩张鳞状细胞，我们将其称为“气球样细胞”。这些细胞常聚集成簇，呈斑片状分布，在胃食管反流患者的活检标本中，在棘细胞层中占主导地位。我们研究了气球样细胞的免疫组化特征及其相关的临床发现。我们通过免疫过氧化物酶技术证明，气球样细胞含有胞质内白蛋白和免疫球蛋白轻链，对角蛋白的染色减少，提示细胞损伤并导致血浆蛋白和液体的摄取。12名正常对照者的食管黏膜活检标本中没有或仅有稀疏的气球样细胞，但在10名经pH值探针试验确诊为胃食管反流的患者中有7名（70%）观察到气球样细胞（与正常对照相比，P = 0.001），在25名临床疑似反流的患者中有16名（64%）观察到气球样细胞（P小于0.001），在5名感染性或化疗相关性食管炎患者中有4名观察到气球样细胞。然而，在气球样细胞与上皮损伤的常见组织病理学标准（如血管襻高度增加或基底区宽度增加）之间未发现一致的关联。我们得出结论，气球样细胞最常见于各种原因导致的食管损伤患者的活检标本中。我们提出，气球样细胞可能是上皮损伤的一个标志物，甚至在缺乏其他损伤组织病理学标准时也可能如此。
