Histopathologic findings of eosinophilic esophagitis in childhood

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by dense tissue eosinophilia (1). In EoE, biopsies show marked eosinophilic infiltrates at different levels of the esophagus. However, the presence of an increased number of eosinophils in the esophageal squamous epithelium is a nonspecific finding that may be seen in several disorders, including reflux esophagitis (RO), infections, drugs and Crohn’s disease (2, 3). In order to distinguish EoE from other causes of mucosal eosinophilia, major and minor histologic criteria for the diagnosis of EoE have been described (4). Major features include epithelial eosinophilia of more than 15 eosinophils/high power field (hpf), and “microabscesses” described as clustering of 4 or more eosinophils and superficial layering of eosinophils. Minor criteria include basal cell hyperplasia (BCH), papiller elongation (PE), spongiosis (intercellular edema) which is currently known as dilated intercellular spaces (DIS), and inflammatory cell infiltration (4, 5). Both major and minor criteria, though helpful, are not pathognomonic for EoE as they may be seen in various types of esophagitis (2). Histopathologic findings of eosinophilic esophagitis in childhood