Esophageal intramural pseudodiverticulosis: A report of two cases with analysis of similar, less extensive changes in “normal” autopsy esophagi

Esophageal intramural pseudodiverticulosis (EIPD) is an uncommon cause of dysphagia. In this report, we describe two cases we encountered at autopsy. In both cases, the pseudodiverticula represented dilated excretory ducts of submucosal mucous glands. In addition, we retrospectively examined histologic sections of esophagus taken randomly from 100 autopsies, and prospectively studied 20 esophagi in a standardized fashion. Our findings suggest that the early pathologic changes of EIPD are more common than is appreciated in the literature. We found submucosal chronic inflammation surrounding mucous glands in more than 60% of esophagi at autopsy. Excretory duct dilatation and small pseudodiverticula were also commonly found, their prevalence related to the number of sections of esophagus studied. The finding of chronic inflammation associated with the earliest degrees of duct dilatation and pseudodiverticula formation suggests that inflammation may play a role in the etiology of this disorder.