Oesophageal hyperkeratosis: clinicopathological associations. Issue 4 (23rd July 2013)

• Record Type: Journal Article
• Authors: Taggart, Melissa W; Rashid, Asif; Ross, William A; Abraham, Susan C
• Is Part Of: Histopathology. Volume 63:Issue 4(2014)
• Page Start: 463
• Page End: 473
• Publication Date: 2013-07-23
• Subjects: Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12195
• Languages: English
• ISSNs: 0309-0167

Abstract

<abstract abstract-type="main" id="his12195-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="his12195-sec-0001" sec-type="section"> <title>Aims</title> <p>Oesophageal hyperkeratosis is rarely described. In contrast to hyperkeratosis of orolaryngeal mucosa, where its risk factors and association with squamous neoplasia are well‐studied, the prevalence and clinicopathological features of oesophageal hyperkeratosis are unknown.</p> </sec> <sec id="his12195-sec-0002" sec-type="section"> <title>Methods and results</title> <p>We reviewed prospectively 1845 oesophageal biopsies and found hyperkeratosis in 37 (2.0%). Among 98 patients studied, hyperkeratosis occurred in two distinct settings: group 1 [within Barrett's oesophagus (BO)/adenocarcinoma, <italic>n </italic>= 61, 62%] and group 2 (outside BO/adenocarcinoma, <italic>n </italic>= 37, 38%). In contrast to group 1, hyperkeratosis in group 2 was more often multifocal (>3 foci in 51% versus 16%, <italic>P </italic>= 0.0001), involved mid‐oesophagus (51% versus 2%, <italic>P </italic>< 0.0001), showed endoscopic leucoplakia (24% versus 3%, <italic>P </italic>= 0.003) and involved current/former alcohol users (51% versus 19%, <italic>P </italic>= 0.0012). Importantly, invasive squamous carcinoma and squamous dysplasia were seen only in group 2 (47% and 19% versus 0%, <italic>P </italic>< 0.0001). Further, 42% of group 2, but none of group 1, had benign or malignant squamous lesions of the oral cavity/larynx (<italic>P </italic>< 0.0001).</p> </sec> <sec id="his12195-sec-0003" sec-type="section"> <title>Conclusion</title> <p>Hyperkeratosis involves ~2% of oesophageal biopsies and can be divided into cases occurring within BO/adenocarcinoma and those occurring outside BO/adenocarcinoma. The former lack clinical significance, whereas the latter are associated frequently with oesophageal squamous neoplasia and squamous pathology of the head and neck region.</p> </sec> </abstract>