Glycogenic acanthosis
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| caption = Endoscopic image of glycogenic acanthosis found incidentally
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| specialty = Gastroenterology
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| differential when numerous lesions are seen Cowden syndrome could be considered. This is an underdiagnosed, underrecognized, autosomal dominant, inherited syndrome which can present with many esophageal acanthosis lesions and multiple hamartomatous polyps. This combination should suggest the diagnosis. Sensitive molecular diagnostic tests looking for mutations in the appropriate genes are clinically available. =
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Glycogenic acanthosis are small raised white plaques commonly seen in the esophageal mucosa.Ghahremani GG, Rushovich AM. Glycogenic acanthosis of the esophagus: radiographic and pathologic features. Gastrointest Radiol. 1984;9(2):93-8. {{PMID|6745598}}. It is seen incidentally in 3.5% of gastroscopies.Vadva MD, Triadafilopoulos G. Glycogenic acanthosis of the esophagus and gastroesophageal reflux. J Clin Gastroenterol. 1993 Jul;17(1):79-83. {{PMID|8409304}}
Signs and symptoms
On gastroscopy, glycogenic acanthosis is seen as a multitude of small white raised plaques of 2 mm to 10 mm in size, which may be seen throughout the esophagus. They tend to occur on esophageal folds, and may be missed if the esophagus is not well distended with air. It may be seen on esophageal x-rays; it is not seen on standard esophograms, but can be seen with double-contrast studies.Glick SN, Teplich SK, Goldstein J, Stead JA, Zitomer N. Glycogenic Acanthosis of the Esophagus. Amer J Radiol 1982139:683-688 Biopsies of the lesions show hypertrophied stratified squamous mucosa with glycogen deposition in the mucosa.
Clinically, mild glycogenic acanthosis is a normal finding, and does not progress to esophageal cancer or to stricture.Pathology Outlines website: http://pathologyoutlines.com/esophagus.html#glycogenic Accessed 6 January 2009. It is not related to leukoplakia, and is not dysplastic or premalignant. It was originally thought to be associated with gastroesophageal reflux disease (GERD), but the association is not entirely clear. One report also shows an association with celiac disease, but again, this has not shown been beyond that. Extensive glycogenic acanthosis has been shown to be associated with Cowden's syndrome.Kay PS, Soetikno RM, Mindelzun R, Young HS. Diffuse esophageal glycogenic acanthosis: an endoscopic marker of Cowden's disease. Am J Gastroenterol. 1997 Jun;92(6):1038-40 {{PMID|9177527}}
Diagnosis
Glycogenic acanthosis is characterized by epithelial hyperplasia, with an increased number of enlarged epithelial cells containing abundant glycogen. There is no associated hyperkeratosis, inflammation, dysplasia, or cellular atypia.
References
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External links
- [http://www.pathologyoutlines.com/images/stomach/03_06.jpg Microscopic images]
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