SAVED
File name
.JPG
File alt. text
Image should be
px wide x
px tall.
Select Image
Select Image
L
O
G
I
N
EXISTING USERS
NEW USERS
password:
Forgotten your password?
password:
LOG IN
REGISTER
The Gastroenterology Training Handbook
For Specialist Registrars
HOME
OESOPHAGUS
•Gastro Oesophageal Reflux Disease
•Oesophageal Cancer
•Oesophageal Dysmotility
•Benign Oesophageal Lesions
•Miscellaneous
•Dysphagia
STOMACH
•Obesity Surgery
•Clinical Presentations of Gastric Conditions
•Gastric Cancer
•Gastric Polyps and Masses
•Peptic Ulcer Disease
•Gastritis and Gastropathy
•Miscellaneous
SMALL BOWEL
•Coeliac Disease
•Small Bowel Infections
•Small Bowel Masses
•Miscellaneous
COLON
•Colorectal and Anal Cancer
•Diagnostic Pathways for Colonic Disease
•Colonic Vascular Disorders
•Anal Diseases
•Various Colitides
•Colonic Motility Disorders
•Miscellaneous
•Colonic Infection
LIVER
•Alcohol
•Liver Failure
•Miscellaneous
•Ascites
•Bilirubin Metabolism
•Vascular Problems
•Clinical Presentations
•Liver Masses
•Hepatitis B
•Hepatitis C
•Autoimmune Conditions
•Metabolic Conditions
•Treatments
•Various Viruses
•Hepatopulmonary Disorders
•Liver Imaging
BILIARY
•Gallstone Disease
•Biliary Cancers
•Biliary Parasites
•Miscellaneous
NUTRITION
•Nutrition Therapy
•Minerals
•Proteins, Fats and Sugars
•Vitamins
•Clinical Conditions and Nutrition
PANCREAS
•Pancreatitis
•Pancreatic Masses and Cysts
•Pancreatic Cancers
•Other
IBD
•Epidemiology
•IBD Diagnosis
•Extra Intestinal Manifestations
•Surgery
•Treatment
MISCELLANEOUS
•Bleeding
•Rheumatological Disease
•Infection
•Vascular Lesions
•Other
home -
Oesophagus -
Benign Oesophageal Lesions -
Benign Raised Lesions
search
Ask a question in the forum
Written by Dr Sebastian Zeki
MCQs for this page
Benign Raised Lesions
View large version
Embed image
paste this code into your webpage / blog to share.
Haemangiomas
The prevalence is 0.04 %.
Histology
shows cavernous vascular spaces.
Endoscopy shows a nodular, soft, bluish red,
and typically blanch when pressed with
biopsy forceps.
The
Treatment
is
endoscopic resection safe
Raised Oesophageal Lesions
Lymphangiomas
These are due to a malformation of seques
-
tered lymphatic tissue.
These lesions are very rare (only 15
described).
Endoscopic features include a
translucent,
yellowish, submucosal, easily compressible
mass.
It is usually < 5 mm.
It is a submucosal lesion.
Treatment is usually not needed but can be
resected if causing problems.
Fibrovascular polyps
These are comprised of fibromas, fibrolipomas, myomas, and
lipomas.
Histology involves fibrous, vascular, and adipose tissue covered by squamous
epithelium.
Lesions are usually in upper third of the oesophagus attached to the inferior
aspect of
cricopharyngeus.
These are more common in males at 3:1.
The average age of onset is in the 50’s.
They arise from nodular thickening of a redundant mucosal fold.
The polyps are usually asymptomatic.
If the patients is symptomatic the polyps usually have a stalk .
Do an EUS- if there is a feeding vessel, need surgery or snare with endoloop.
If there is no feeding vessel, snare polypectomy is appropriate.
Granular cell tumors
Granular cell tumors occur in the skin, tongue, breast,
and gastrointestinal tract.
10% of the lesions occur in the GI tract, 65% of these in
the oesophagus.
The average age of detection is 45 years.
They are more common in males than females.
These are usually asymptomatic but dysphagia can
occur in 30%.
Endoscopic
features include sessile, yellowish white,
and are covered by normal-appearing mucosa. 90% are
solitary.
The lesions are
histologically
composed of large
polygonal cells containing numerous eosinophilic
granules.
They resemble Schwann cells under electron micros
-
copy and stain positive for S100 protein, suggesting a
neural origin.
The lesions have malignant potential especially if >4cm
so these should be resected.
They can be surveyed every 1-2 years.
Only occur in Barretts- see Barrett’s section
Inflammatory fibroid polyps
This is composed of reparative tissue.
The lesions can be due to reflux.
Lesions include
hamartomas,
inflammatory pse
-
dopolyps, and eosinophilic granulomas.
Lesions are mainly found in distal oesophagus.
Histological
features
include ia connective tissue
stroma and a diffuse eosinophilic infiltrate.
Treatment
involves
resection only if troublesome.
Papillomas
The incidence is 0.02%
Histology
involves epithelium
lined by an
increased number of squamous cells.
There is a core of connective tissue with small
blood vessels.
The lesion is possibly associated with GERD or NG
tube insertion.
Endoscopy usually shows a solitary small, whitish
pink, wart-like exophytic projection
Clinical manifestations
Age: 50s; M=F
Treatment
involves
EMR
if >1cm or
<1cm cold biopsy/snare.
Recurrence after resection is infrequent.
Gastrointestinal stromal tumors,
leoimyomas, and leoimyosarcomas
See
GIST
section
Treatment:
Adenomas
Treatment:
Papilloma associations:
Tylosis.
Acanthosis
nigricans.
Goltz syndrome (congenital focal dermal
hypoplasia that features hyperpigmentation,
sclerodactyly, dysplastic changes of the teeth
and bones, and perianal, oroesophageal, and
genital papillomas.
Histology:
Dilated endothelial spaces with cavities lined by
flat endothelial cells containing eosinophilic
material.
Written by Dr Sebastian Zeki
Related Stories
•
•
•
•
•