Leukoplakia
Introduction
Introduction to esophageal white spot The mucosa is hyperkeratotic, that is, white plaque changes, called white spots. Esophageal leukoplakia is a rare disease that can be used as a partial manifestation of mucosal leukoplakia or as an esophageal disease. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications:
Cause
Esophageal leukoplakia
(1) Causes of the disease
Long-term persistent stimuli, such as strong alcohol and tobacco, spicy food and overheated diet, and unhealthy oral cavity are all causes of hyperkeratosis. In addition, such as anemia, endocrine disorders, cirrhosis, systemic progressive sclerosis Factors such as fungal infections also affect the normal keratinization process of the epithelium.
(two) pathogenesis
The epithelial layer is hyperkeratotic and has different degrees of keratosis. The spinous cell layer is thickened. The extensive edema inside and outside the spine cells causes intracellular rupture. The dermis has mild inflammatory cell infiltration. At autopsy, there is diffuse throughout the esophagus. White spots, like white bark, involving the entire esophagus, or scattered white spots with patches or plaques, endoscopy showed that the esophageal mucosa is all white or scattered white plaques, higher or slightly higher than normal mucosa, white spots The normal mucosa is seen. Some biopsy shows that some leukoplakia are thickened by spine cells and contain a lot of glycogen. Therefore, this leukoplakia is called glycogenic acanthosis, and biopsy can rule out diseases such as fungi and cancer.
Prevention
Esophageal leukoplakia prevention
The various pathogenic factors that cause white spots should be removed, smoking and drinking, and not eating too hot and cold and spicy food.
1. Change bad eating habits, do not eat moldy food, eat less or not eat sauerkraut.
2. Improve water quality and reduce nitrite content in drinking water.
3. Promote trace element fertilizers and correct the trace elements such as molybdenum deficiency in soil
4. Susceptible crowd monitoring, popularizing medical knowledge and improving medical knowledge.
Complication
Esophageal leukoplakia complications Complications
It is necessary to pay attention to the clinical situation. If the leukoplakia damage is rapidly enlarged, the basement is indurated, the sacral protrusion or obvious pain occurs, it should be highly vigilant, and strive for early biopsy and treatment to eliminate the possibility of precancerous damage.
Symptom
Esophageal leukoplakia symptoms common symptoms dysphagia post-sternal pain
White spots are more common in male patients over the age of 40. Generally, there are no obvious symptoms. The late white spots are particularly sensitive to heat and irritating foods. If the leukoplakia rapidly enlarges, thickens, splits, ruptures, and induration, post-sternal pain may occur and should be further examined to rule out cancer.
More common in men over the age of 40, generally no symptoms. If the leukoplakia is large and thick, it may have difficulty swallowing or sternal pain when it is broken or indurated. If you have progressive dysphagia, you should check it regularly to see if there is any possibility of cancer.
Examine
Esophageal leukoplakia examination
Esophagoscopy is an important means of diagnosing this disease. Endoscopic examination shows scattered white plaques. In severe cases, all esophagus is whitish. White plaques are slightly higher than normal mucosa, or there are cleft palate, secondary ulcers, normal between white spots. Mucosa, biopsy leukoplakia is thickened by spine cells and contains a large amount of glycogen. If the leukoplakia is large, the basement is indurated, and the sacral protrusion should be taken from multiple biopsy to understand whether there is cancer.
Diagnosis
Diagnosis of esophageal leukoplakia
diagnosis
More common in men over 40 years old, generally no symptoms, if the leukoplakia is larger, thicker, accompanied by ulceration, induration may have difficulty swallowing or sternal pain, if there is progressive dysphagia should be regularly reviewed to see if there is Cancer is possible.
Differential diagnosis
1. Suppurative esophagitis: suppurative esophagitis is the most common mechanical damage caused by foreign bodies, bacteria in the esophageal wall, causing local inflammatory exudation, varying degrees of tissue necrosis and pus formation, can also be more extensive cellulitis.
2. Esophageal tuberculosis: patients with esophageal tuberculosis generally have other pioneer symptoms of tuberculosis, especially tuberculosis. The symptoms of the esophagus are often confused or concealed by other organ symptoms, so that they cannot be discovered in time. According to the pathological process of tuberculosis, the early stage of infiltration can be There are symptoms of fatigue, low fever, increased erythrocyte sedimentation rate, but also symptoms are not obvious, followed by swallowing discomfort and progressive dysphagia, often accompanied by persistent throat and retrosternal pain, aggravation when swallowing, ulcer-type lesions Most of them are characterized by pain when swallowing. Food spilling into the trachea should consider the formation of tracheal esophageal fistula. Difficulty in swallowing suggests that the fibrosis of the lesion causes scarring.
3. Fungal esophagitis: the clinical symptoms of fungal esophagitis are atypical, some patients can have no clinical symptoms, common symptoms are swallowing pain, difficulty swallowing, upper abdominal discomfort, post-sternal pain and burning sensation, severe sternal rear It is like a knife-like colic, which can radiate to the back like angina. Candida esophagitis can cause severe bleeding but is not common. Untreated patients may have epithelial shedding, perforation or even disseminated candidiasis, and esophageal perforation can cause Mediastinal inflammation, esophageal tracheal fistula and esophageal stricture, patients with persistent high fever granulocytopenia should be checked for skin, liver, spleen, lung and other disseminated acute candidiasis.
4. Viral esophagitis: HSV infection of the esophagus often has nasal and herpes labia. The main symptom is swallowing pain. The pain is often aggravated when swallowing food. The patient's food is slow in the esophagus after swallowing. A few patients have difficulty swallowing. The main symptoms, mild infection can be asymptomatic.
