Читать книгу The Esophagus - Группа авторов - Страница 177

Lichen planus is a chronic inflammatory condition involving the skin, mucous membranes, and, less commonly, the esophagus. Esophageal involvement predominantly occurs in elderly women with long‐standing dysphagia and associated skin lesions [106], but 50% of these patients experience dysphagia before the development of cutaneous disease [107]. Esophageal lichen planus may be manifested on barium studies by segmental strictures in the cervical or thoracic esophagus or, even more commonly, by a small‐caliber esophagus with diffuse, smooth esophageal narrowing (Figure 6.55) indistinguishable from that in EoE (see Figure 6.54) [108]. However, EoE typically occurs in young men with an atopic history, asthma, and/or peripheral eosinophilia [102], whereas lichen planus occurs in elderly women, often with associated cutaneous lesions. When esophageal lichen planus is suspected on the basis of the clinical and radiographic findings, the diagnosis can be confirmed on endoscopic biopsy specimens showing a lymphocytic infiltrate with keratinocyte degeneration and characteristic Civatte bodies (i.e. necrotic keratinocytes) [109].

Figure 6.42 Feline esophagus. Double‐contrast view shows delicate transverse folds as a transient finding in the esophagus. Contrast this image to the fixed transverse folds in the distal esophagus in Figure 6.40.