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Oesophagus and Stomach
Inside view
An interesting pill to swallow
  1. Karishma Sethi1,
  2. Sami Hoque2
  1. 1 Department of Gastroenterology, Homerton University Hospital NHS Foundation Trust, London, UK
  2. 2 Gastroenterology, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Karishma Sethi, Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK; karishma.sethi2{at}nhs.net

https://doi.org/10.1136/flgastro-2019-101342

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    Case

    A 60-year-old woman presented with dysphagia and weight loss. Medical history was significant for oral and vulval lichen planus. Barium swallow and CT scanning revealed no abnormality. Oesophago-gastro-duodenoscopy demonstrated an ulcerated stricture in the upper oesophagus, 25 cm from the incisors (figure 1), with friable, exfoliating mucosa. Biopsies revealed chronic ulceration, degeneration of the basal epithelium, a dense junctional lymphocytic infiltrate and Civatte bodies (figure 2).

    Figure 1

    Oesophageal stricture with ulcerated, friable mucosa with sloughing.

    Figure 2

    Oesophageal biopsies showing lymphocytic inflammation with Civatte bodies.

    Question

    What abnormality is seen in the endoscopic image and histology slide? How is this condition managed?

    Answer

    A diagnosis of oesophageal lichen …

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    Footnotes

    • Contributors KS has written the manuscript and is the first and corresponding author. SH is the second author and has contributed to and critically appraised the manuscript. Neither author has any competing interests.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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