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Look for signs of (reflux) esophagitis, mainly:
- Inflammatory cells, especially when intra-epithelial. Neutrophils confer a diagnosis of acute inflammation, while plasma cells, eosinophils and excess T cells confer a diagnosis of chronic inflammation. In eosinophil-predominant inflammation, also evaluate as suspected eosinophilic esophagitis.
- Basal cell hyperplasia exceeding 15 - 20% of the epithelial thickness.
- Stromal papillae reaching upper third of the epithelium.
- Loss of orientation of superficial epithelial cells.
- Ballooned squamous cells
- Elliot Weisenberg. Esophagus - Esophagitis - Reflux esophagitis / gastroesophageal reflux disease. Pathology Outlines. Topic Completed: 1 October 2012. Minor changes: 8 July 2020