Other nonneoplastic


Topic Completed: 1 December 2012

Minor changes: 17 December 2020

Copyright: 2003-2021,, Inc.

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

Elliot Weisenberg, M.D.
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Cite this page: Weisenberg E. Ulcer. website. Accessed October 22nd, 2021.
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

AFIP images

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
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