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首页> 外文期刊>World Journal of Gastroenterology >Sporadic ganglioneuromatosis of esophagogastric junction in a patient with gastro-esophageal reflux disorder and intestinal metaplasia.
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Sporadic ganglioneuromatosis of esophagogastric junction in a patient with gastro-esophageal reflux disorder and intestinal metaplasia.

机译：胃食管反流障碍和肠上皮化生的患者的食管胃交界性神经节神经瘤病。

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摘要

A 58-year-old female with a recurrent history of upper abdominal pain and intermittent dysphagia underwent endoscopic evaluation that demonstrated an irregular and nodular esophago-gastric (EG) junction and grade I erosive esophagitis. Biopsies showed prominent intestinal metaplasia of Barrett's type without dysplasia, chronic inflammation and multiple aggregates of large cells within the mucosal lamina propria, some with spindle shaped nuclei. Immunohistochemistry stains for keratins AE-1/AE-3 were negative, while S-100 and NSE were positive. This, together with routine stains, was diagnostic for mucosal ganglioneuromatosis. The background of chronic inflammation with intestinal type metaplasia was consistent with long-term reflux esophagitis. No evidence of achalasia was seen. Biopsies of gastric antrum and fundus were unremarkable, without ganglioneural proliferation. Colonoscopy was unremarkable. No genetic syndromes were identified in the patient including familial adenomatous polyposis and multiple endocrine neoplasia type IIb (MEN IIb). Iansoprazole (Prevacid) was started by oral administration each day with partial relief of symptoms. Subsequent esophagogastroscopy repeated at 4 mo showed normal appearing EG junction. Esophageal manometry revealed a mild non-specific lower esophageal motility disorder. Mild motor dysfunction is seen with gastro-esophageal reflux disease (GERD) and we feel that the demonstration of localized ganglioneuromatosis was not likely related etiologically. In the absence of findings that might suggest neural hypertrophy, such as achalasia, the nodular mucosal irregularity seen with this instance of ganglioneuromatosis may, however, have exacerbated the patient's reflux.
机译：一名58岁的女性，该女性具有上腹部疼痛和间歇性吞咽困难的复发史，接受了内镜检查，该检查显示出不规则和结节性食管胃（EG）交界处和I级糜烂性食管炎。活检显示Barrett型肠上皮化生突出，无异常增生，慢性炎症和粘膜固有层内大细胞的多聚集体，其中一些具有纺锤形核。角蛋白AE-1 / AE-3的免疫组织化学染色阴性，而S-100和NSE阳性。这与常规污渍一起可诊断粘膜神经节瘤病。肠型化生的慢性炎症与长期反流性食管炎相一致。没有发现门失弛缓症的证据。胃窦和眼底活检无异常，无神经节细胞增生。结肠镜检查无异常。在该患者中未发现遗传综合征，包括家族性腺瘤性息肉病和IIb型多发内分泌肿瘤（MEN IIb）。每天通过口服给药开始用Iansoprazole（Prevacid）缓解部分症状。随后在4 mo重复进行的胃镜检查显示正常出现的EG连接。食管测压发现轻度非特异性下段食管运动障碍。胃食管反流病（GERD）可见轻度运动功能障碍，我们认为局部神经节神经瘤病的病因学与病因无关。在没有发现可能提示神经肥大的发现（例如门失弛缓症）的情况下，这种神经节神经瘤病病例见到的结节性粘膜异常可能加剧了患者的反流。

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