Читать книгу Gastrointestinal Pathology - Группа авторов - Страница 79

The major histologic differential diagnostic consideration is infection, particularly fungal (Candida) or viral (HSV, CMV), which may need to be excluded with appropriate histochemical and immunohistochemical stains or recognized by characteristic viral cytopathic effect. In rare cases, exuberant granulation tissue and excessive exudates mimic the gross appearance of a neoplasm. If eosinophils are prominent, reflux or eosinophilic esophagitis may enter into the differential diagnosis. GVHD should be excluded if prominent apoptosis is present, such as with mycophenolate injury. Finally, lichen planus involvement of the proximal esophagus with stricture formation can also mimic drug injury. In all of these considerations, the clinical context is critical to the evaluation of the histopathologic findings.

Figure 2.16 (a) Iron tablet erosive esophagitis with fibrinopurulent debris. (b) The Prussian Blue iron stain is diagnostic.