Heterotopic Gastric Mucosa in the Upper Esophagus, Report of Two Cases Masanori Morita 1 , Yoshiya Sakamoto 1 , Yoshihiko Nakazawa 1 , Yasuro Yamamoto 1 , Yasutake Yamamoto 1 1The First Department of Internal Medicine, Kochi Medical School pp.539-542
Published Date 1988/5/25
DOI https://doi.org/10.11477/mf.1403108128
  • Abstract
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 The etiology of ectopic gastric mucosa in the upper esophagus is considered an incomplete replacement of columnar epithelium by squamous cell epithelium in the embryonal period. By endoscopic observation, it was revealed that the incidence of ectopic gastric mucosa in the upper esophagus is about 4% in Europe and America but only 0.45% in Japan.

 We reported two cases of heterotopic gastric mucosa that covered a large area in the upper esophagus. One case was a 44-year-old man who was complaining of epigastric discomfort. Endoscopic examination revealed three patches of ectopic gastric mucosa, each with a size of more than 10 mm, at a distance of 17 to 20 cm from the incisor teeth. By Congo red staining method using tetragastrin, an acidic secretion of gastric mucosa was revealed. Microscopical findings of biopsy specimen showed gastric-like glands which contained parietal cells.

 Another case was that of a 43-year-old man who had no complaints of discomfort. Endoscopic findings showed three patches of ectopic gastric mucosa, each with a size of about 10 mm, in the upper esophagus. Histopathological findings showed the mucosa-like gastric epithelium, which contained no parietal cells. Ectopic gastric mucosa is commonly located just below the upper esophageal sphincter, and it is difficult to detect endoscopically. Careful observation is necessary. Since a few cases of esophageal adenocarcinoma derived from ectopic gastric mucosa have been reported from time to time in Japan and Germany, our cases need to be followed-up carefully.

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