Diagnostic pitfall of sebaceous gland metaplasia of the esophagus

Abstract

We investigated the sebaceous gland metaplasia (SGM) of the esophagus and clarified the evidence of misdiagnosis and its diagnosis pitfall. Cases of pathologically proven SGM were enrolled in the clinical analysis and reviewed description of endoscope. In the current study, we demonstrated that SGM is very rare esophageal condition with an incidence around 0.00465% and an occurrence rate of 0.41 per year. There were 57.1% of senior endoscopists identified 8 episodes of SGM. In contrast, 7.7% of junior endoscopists identified SGM in only 2 episodes. Moreover, we investigated the difference in endoscopic biopsy attempt rate between the senior and junior endoscopist (P = 0.0001). The senior endoscopists had more motivation to look for SGM than did junior endoscopists (P = 0.01). We concluded that SGM of the esophagus is rare condition that is easily and not recognized in endoscopy studies omitting pathological review.

Keywords: Endoscopist; Endoscopy; Esophagus; Metaplasia; Sebaceous gland.

Figure 1

Sebaceous gland metaplasia in the esophagus. Numerous tiny round yellowish lesions clustering distribution at the submucosa of the middle and lower esophagus.

Figure 2

Esophageal squamous epithelial with sebaceous glands (HE stained × 400).

Figure 3

Photograph. A: Candida infection of the esophagus. Multiple small brightly whitish elevated patches at the upper and middle esophagus; B: Papilloma of the esophagus. A single round whitish elevated nodule at the middle esophagus; C: Glycogenic acanthosis of the esophagus. Some small round lucent to lightly whitish nodules at the upper and middle esophagus.