We report a case of epidermoid metaplasia of the esophageal mucosa that developed in a patient with a long history of esophageal intramural pseudodiverticulosis (EIPD) complicated by candidiasis. The patient, a 69-year-old man, had been treated for about 3 years for EIPD with candidiasis. After candidiasis improved, the development of epidermoid metaplasia of the esophageal mucosa was observed. It comprised longitudinally arranged, multiple, small, whitish flecks with a scaly appearance on the mucosa of the middle to lower esophagus, and pathological examination demonstrated several fine keratohyalin granules in superficial layers of the squamous epithelium. Six months later, candidiasis was almost cured, but these small flecks had slightly increased in size, and pathological examination demonstrated epidermoid metaplasia consisting of a thick, acellular keratin layer and well-developed granular layer beneath it. We considered that chronic candida esophagitis played the principal pathogenetic role in the development of epidermoid metaplasia. EIPD may have provided an environment suitable for the growth of fungi, and mucinous material contaminated by Candida and excreted from the orifices of EIPD may have irritated the mucosa and induced epidermoid metaplasia.
Case Rep Gastroenterol 2021;15:709–714

中文翻译：

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食管壁间假性憩室病和念珠菌病相关黏膜表皮样化生的发展

我们报告了一例食管黏膜表皮样化生的病例，该病例发生于一名长期患有食管壁内假憩室病 (EIPD) 并并发念珠菌病的患者。该患者是一名 69 岁的男性，因念珠菌病 EIPD 接受了大约 3 年的治疗。念珠菌病好转后，可见食道黏膜表皮样化生。它包括纵向排列的多发小白色斑点，在中下食管粘膜上有鳞状外观，病理检查显示鳞状上皮浅层有几个细小的透明角质颗粒。六个月后，念珠菌病几乎治愈，但这些小斑点的大小略有增加，病理检查显示表皮样化生由厚的、脱细胞角蛋白层和其下发育良好的颗粒层。我们认为慢性念珠菌性食管炎在表皮样化生的发展中起主要致病作用。EIPD 可能提供了一个适合真菌生长的环境，以及被真菌污染的粘液物质。从 EIPD 孔口排出的念珠菌和分泌物可能刺激黏膜并诱发表皮样化生。
Case Rep Gastroenterol 2021；15:709–714