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Civatte Bodies in Pediatric Esophageal Biopsies: Does Lichen Esophagitis Pattern Occur in Children?
Pediatric and Developmental Pathology ( IF 1.9 ) Pub Date : 2022-04-22 , DOI: 10.1177/10935266221090081
Mario W Saab-Chalhoub 1 , Hernán Correa 2 , Julia L Anderson 3 , Alexandra E Kovach 2 , Safia N Salaria 1
Affiliation  

PURPOSE AND CONTEXT Civatte bodies (CB) are associated with cutaneous and mucosal lichen planus in adults. They are a distinct feature of Lichen Esophagitis Pattern, which is not well described in children. We characterized clinicopathologic associations of archival esophageal CB at our Children's Hospital to determine whether lichen planus or Lichen Esophagitis Pattern occurs in children. METHOD Pathology records were queried for pediatric esophageal biopsy diagnoses containing "CB," "apoptosis, "necrosis," or "dyskeratosis." Cases with concurrent eosinophilic/acute esophagitis were excluded. H&E slides and clinical reports were reviewed. KEY RESULTS Biopsies with CB or similar were identified from 19 patients and had been termed "dyskeratotic cells" in 8 reports. Patients had variable age and presenting symptoms, male predominance (74%), and frequent clinical history of polypharmacy (47%), Crohn disease (42%), and/or celiac disease (21%). Civatte bodies were prominent in the distal esophagus (95%), as few isolated cells (63%), and with variable chronic inflammation (absent, pauci-inflammatory, and lichen planus-like in approximately one-third of cases each). CONCLUSIONS We show that esophageal CB from pediatric patients are under-recognized and may have different features and implications compared to Lichen Esophagitis Pattern in adults. Recognition and documentation of pediatric esophageal CB is needed to understand their clinical significance.

中文翻译:

小儿食管活检中的 Civatte 体:儿童是否会发生苔藓食管炎模式?

目的和背景 西瓦特小体 (CB) 与成人皮肤和黏膜扁平苔藓有关。它们是苔藓食管炎模式的一个显着特征,在儿童中没有得到很好的描述。我们在儿童医院对档案食管 CB 的临床病理学关联进行了表征,以确定儿童是否发生扁平苔藓或苔藓食管炎模式。方法查询病理记录中包含“CB”、“细胞凋亡”、“坏死”或“角化不良”的小儿食管活检诊断。排除并发嗜酸性粒细胞/急性食管炎的病例。回顾H&E幻灯片和临床报告。关键结果用CB活检从 19 名患者中鉴定出或类似的细胞,并在 8 份报告中被称为“角化不良细胞”。患者的年龄和症状各不相同,男性占优势(74%),并且经常出现多种药物治疗(47%)、克罗恩病(42%)和/或乳糜泻(21%)的临床病史。Civatte 小体在食管远端 (95%) 突出,分离的细胞很少 (63%),并伴有不同程度的慢性炎症(各有三分之一的病例中不存在、少炎症和扁平苔藓样)。结论 我们表明,与成人苔藓样食管炎模式相比,儿科患者的食管 CB 认识不足,并且可能具有不同的特征和影响。需要识别和记录小儿食管 CB 以了解其临床意义。Civatte 小体在食管远端 (95%) 突出,分离的细胞很少 (63%),并伴有不同程度的慢性炎症(各有三分之一的病例中不存在、少炎症和扁平苔藓样)。结论 我们表明,与成人苔藓样食管炎模式相比,儿科患者的食管 CB 认识不足,并且可能具有不同的特征和影响。需要识别和记录小儿食管 CB 以了解其临床意义。Civatte 小体在食管远端 (95%) 突出,分离的细胞很少 (63%),并伴有不同程度的慢性炎症(各有三分之一的病例中不存在、少炎症和扁平苔藓样)。结论 我们表明,与成人苔藓样食管炎模式相比,儿科患者的食管 CB 认识不足,并且可能具有不同的特征和影响。需要识别和记录小儿食管 CB 以了解其临床意义。结论 我们表明,与成人苔藓样食管炎模式相比,儿科患者的食管 CB 认识不足,并且可能具有不同的特征和影响。需要识别和记录小儿食管 CB 以了解其临床意义。结论 我们表明,与成人苔藓样食管炎模式相比,儿科患者的食管 CB 认识不足,并且可能具有不同的特征和影响。需要识别和记录小儿食管 CB 以了解其临床意义。
更新日期:2022-04-22
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