Endoscopic diagnosis of esophageal inflammation

The histologic appearance of biopsy specimens, taken from the distal esophagus of 10 normal subjects and 57 patients with endoscopic evidence of esophagitis, has been reviewed. While only 10% of normal subjects demonstrated a polymorphonuclear leukocyte infiltrate of the mucosa or lamina propria, such an infiltrate was present in more than 80% of patients with an esophageal mucosa of abnormal appearance. Mononuclear cell infiltrates of the lamina propria were seen in both normal and esophagitis patients and their presence does not seem to be a useful criterion for the diagnosis of esophagitis. Careful inspection of the vascular pattern of the distal esophagus with the Olympus GIF endoscope is helpful in detecting cases of mild esophagitis, and a fine nodularity of the mucosa on close inspection is also a useful sign of esophageal inflammation.