Nonneoplastic disorders

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 17 January 2018, last major update December 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Ulcer[TI] esophageal[TI] full text[sb]

Cite this page: Weisenberg, E. Ulcer. website. Accessed November 18th, 2018.
Definition / general
  • Usually caused by chronic gastroesophageal reflux
  • Consider infectious causes if exudate present
  • Also consider drugs, radiation, dermatologic disease, rheumatologic disorders (Yonsei Med J 2002;43:457)
Case reports
Clinical images

Images hosted on other servers:

Mid esophageal ulcer due to azithromycin

Microscopic (histologic) description
  • Granulation tissue with scattered large, atypical mesenchymal cells resembling carcinoma but not forming solid clusters
  • Adjacent epithelium has reactive changes and prominent hyperplasia (pseudoepitheliomatous hyperplasia) that appear as uniformly thick, parallel prongs of primitive squamous cells that penetrate the granulation tissue of the ulcer bed
  • Cells have minimal cytoplasm, large pleomorphic and hyperchromatic nuclei and prominent nucleoli
  • Mitotic figures common
  • May appear invasive with tangential sectioning
Microscopic (histologic) images

Images hosted on PathOut server:

Surface of healing ulcer

Large abnormal spindle cells

Long prongs of undifferentiated cells

Images hosted on other servers:

Granulation tissue overlying submucosal glands

Negative stains
  • Atypical cells in ulcer bed are keratin negative