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Open Access Highly Accessed Case report

A case of eosinophilic esophagitis discovered with positron emission tomography imaging: a case report

Bryce D Haslem1, Megan I Samuelson2 and Ron Schey1*

Author Affiliations

1 Department of Medicine, Division of Gastroenterology & Hepatology, Univeristy of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA

2 Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA

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Journal of Medical Case Reports 2013, 7:187  doi:10.1186/1752-1947-7-187

Published: 15 July 2013

Abstract

Introduction

Eosinophilic esophagitis was first reported in 1978, and since then it has been increasingly recognized as one of the major etiologies for dysphagia, food impaction, and food regurgitation. To the best of our knowledge, no case of eosinophilic esophagitis (excluding esophageal eosinophilia not responsive to proton pump inhibitor treatment) has previously been demonstrated on the basis of positron emission tomography imaging.

Case presentation

A 68-year-old Caucasian man presented with dysphagia to solids with recurrent regurgitation and weight loss of 7lb within the preceding 2 months. The patient attributed these symptoms to radiation therapy he had received 1 year earlier for squamous cell cancer of the lung. The patient underwent routine follow-up positron emission tomography imaging, which showed a hypermetabolic lesion in the posterior mediastinum and was increased at the level of the midesophagus.

Conclusion

To the best of our knowledge, this is the first reported case of eosinophilic esophagitis demonstrated by positron emission tomography imaging and confirmed with endoscopic evaluation and biopsies both after positron emission tomography imaging and a trial of proton pump inhibitor therapy. This could have an impact on the diagnostic evaluation of esophageal eosinophilic inflammation as well as eosinophilic infiltration of other gastrointestinal organs.