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. .] 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. ]
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.
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
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...
(GERD), but the association is not entirely clear.
One report also shows an association with
celiac disease
Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye and barle ...
, 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 ]
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
Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
, dysplasia, or cellular
atypia
Atypia (from Greek, ''a'' + ''typos'', without type; a condition of being irregular or nonstandard) is a histopathologic term for a structural abnormality in a cell, i.e. it is used to describe atypical cells.
Atypia can be caused by an infection ...
.
References
External links
Microscopic images
{{DEFAULTSORT:Glycogenic Acanthosis
Esophagus disorders