Esophagus
Congenital anomalies
Heterotopic / ectopic sebaceous glands
Author: Yukihiro Nakanishi, M.D., Ph.D.
Editorial Board Member: Raul S. Gonzalez, M.D.
Deputy Editor-in-Chief: Catherine E. Hagen, M.D.
Last author update: 6 May 2021
Last staff update: 11 October 2022
Copyright: 2003-2025, PathologyOutlines.com, Inc.
PubMed Search: Ectopic sebaceous glands [TI]
Table of Contents
Definition / general | Essential features | Terminology | ICD coding | Epidemiology | Sites | Etiology | Clinical features | Diagnosis | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Sample pathology report | Differential diagnosis | Board review style question #1 | Board review style answer #1 | Board review style question #2 | Board review style answer #2Cite this page: Nakanishi Y. Heterotopic / ectopic sebaceous glands. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophagusectopicsebaceousglands.html. Accessed January 20th, 2025.
Definition / general
- Heterotopic / ectopic sebaceous glands in the esophagus
Essential features
- Incidentally found, small (3 - 4 mm) yellowish plaques with granular or lobulated appearance; the number of lesions varies from single to more than 100
- Mature sebaceous gland with excretory duct within the lamina propria of the esophagus
- Asymptomatic and benign; no need for treatment
Terminology
- Ectopic sebaceous gland
- Heterotopic sebaceous gland
ICD coding
- ICD-10: K22.8 - other specified diseases of esophagus
Epidemiology
- Reported incidence is low:
- 0.005% (World J Clin Cases 2014;2:311)
- 0.05% (Dis Esophagus 2017;30:1)
- Reported age range:
- 45 - 79 years (World J Gastroenterol 2015;21:1091, Clin Endosc 2018;51:495, Case Rep Gastroenterol 2012;6:217, Pathol Int 1999;49:364)
- Has not been reported in pediatric patients
- Reported median age:
- 52 years (range 45 - 69 years) (World J Gastroenterol 2015;21:1091)
- 57.6 years (46 - 71 years) (World J Clin Cases 2014;2:311)
- Reported male to female ratios:
Sites
- Middle and lower esophagus (World J Clin Cases 2014;2:311, Dig Dis Sci 2019;64:2049, Case Rep Gastroenterol 2012;6:217, Clin Endosc 2018;51:495, Pathol Int 1999;49:364)
Etiology
- Whether heterotopic / ectopic sebaceous glands in the esophagus are the result of congenital anomaly or metaplastic change of squamous epithelium remains unknown (Pathol Int 1999;49:364)
- Since the esophagus is of endodermal origin, while sebaceous glands are of ectodermal origin, metaplastic change of squamous epithelium is suspected
Clinical features
- Incidentally found, small, yellowish plaques
- Usually asymptomatic
Diagnosis
- Confirmed via biopsy (Clin Endosc 2018;51:495, Case Rep Gastroenterol 2012;6:217)
Case reports
- 47 year old man with several yellow plaques and 63 year old man with multiple yellowish patches (Clin Endosc 2018;51:495)
- 56 year old man with more than 100 yellowish plaques measuring 1 - 20 mm in diameter (Case Rep Gastroenterol 2012;6:217)
- 78 year old woman with numerous 3 - 4 mm plaques in the middle and distal esophagus (Dig Dis Sci 2019;64:2049)
- 79 year old man with numerous esophageal heterotopic sebaceous glands accompanied by superficial esophageal cancer (Pathol Int 1999;49:364)
Treatment
- No treatment required
Gross description
- Randomly distributed, small (3 - 4 mm) yellowish plaques with granular or lobulated appearance
- Number of lesions varies from single to more than 100
- References: Pathol Int 1999;49:364, Clin Endosc 2018;51:495, Case Rep Gastroenterol 2012;6:217
Gross images
Images hosted on other servers:
Endoscopic images
Microscopic (histologic) description
- Mature sebaceous glands characterized by large polygonal cells with clear, vacuolated cytoplasm within the lamina propria
- A squamous lined excretory duct may also be present
- Associated hair follicles or other skin appendages are absent
Microscopic (histologic) images
Contributed by Yukihiro Nakanishi M.D., Ph.D. and @MirunaPopescu13 on Twitter
Intermediate power
Heterotopic / ectopic sebaceous glands
Sample pathology report
- Esophagus, mid, biopsy:
- Heterotopic / ectopic sebaceous gland
- Negative for dysplasia or carcinoma
Differential diagnosis
- Xanthoma (Clin Endosc 2014;47:358):
- Grossly yellowish plaques, commonly solitary
- Aggregates of foamy macrophages beneath the squamous epithelium
- Glycogenic acanthosis:
- Acanthotic squamous epithelium with clear (glycogen containing) cytoplasm
- Squamous papilloma:
- Wart-like exophytic lesion
- Papillary proliferation of benign squamous epithelium
- Heterotopic / ectopic gastric mucosa:
- Salmon colored mucosa located just below the upper esophageal sphincter composed of heterotopic / ectopic gastric fundic glands
- Granular cell tumor:
- Small submucosal nodule composed of polygonal cells with small nuclei and abundant eosinophilic granular cytoplasm
- Positive for S100, calretinin and CD68
- Candidiasis:
- Whitish plaques with histologic evidence of pseudohyphae and yeast forms
- Well differentiated neuroendocrine tumor:
- Extremely rare in the esophagus
- Positive for neuroendocrine markers
Board review style question #1
Which of the following is true about the esophageal lesion shown in the above picture?
- Associated hair follicles are occasionally seen
- Excretory ducts can be seen
- Lesions are always multiple
- Usually seen in the submucosa
Board review style answer #1
B. Excretory ducts can be seen in heterotopic / ectopic sebaceous glands of the esophagus.
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Board review style question #2
Which of the following is true about heterotopic / ectopic sebaceous glands of the esophagus?
- Characterized by small (3 - 4 mm) yellowish plaques with granular or lobulated appearance
- Gastroesophageal reflux disease is one of the etiologic factors
- Most patients are elderly males with abnormal lipid metabolism disorders
- Often seen in pediatric patients
Board review style answer #2
A. Small (3 - 4 mm) yellowish plaques with granular or lobulated appearance are characteristic endoscopic features.
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