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Proximal esophagus biopsy shows squamous mucosa with mild chronic inactive inflammation (hematoxylin and eosin stain; original magnification ×100).
Source publication
Patient: Female, 48
Final Diagnosis: Plummer-Vinson syndrome
Symptoms: Chest pain • fatigue • palpitation
Medication: —
Clinical Procedure: Esophagogastroduodenoscopy (EGD) • colonoscopy
Specialty: General and Internal Medicine
Objective
Rare disease
Background
Plummer-Vinson syndrome (PVS) is a rare disorder composed of the triad of dysphagia, i...
Context in source publication
Context 1
... were obtained from the proximal and distal esophagus with cold forceps for suspected eosinophilic esophagitis versus Plummer-Vinson syndrome, based on gross appearance. A pathology exam of the esophagus showed squamous-only mucosa, with mild chronic inactive inflammation (Figure 2). No eosinophilia was seen. ...
Citations
... PVS cases share a predominant female preponderance and are relatively uncommon or under-reported in African Americans [2][3][4][5][6]. This striking female preponderance can be explained by a higher prevalence of iron deficiency among women due to lower dietary intake, menstrual blood loss, and pregnancy [7]. ...
Plummer-Vinson syndrome (PVS) constitutes a triad of iron deficiency anemia, dysphagia, and cervical esophageal webs. It has usually been described in Caucasian women but rarely reported in African American women despite a high prevalence of iron deficiency anemia. We report a 32-year-old African American female with a history of iron deficiency anemia secondary to menorrhagia, who presented with progressive weakness and dysphagia. Her bloodwork revealed severe iron deficiency anemia, and upper endoscopy showed a single esophageal web that underwent Savary-Gilliard dilation. In African Americans, PVS should be suspected if concurrent dysphagia with iron deficiency anemia is present. Guidelines regarding endoscopic surveillance are yet to be studied, and long-term and comparable data, including trials of endoscopic monitoring for PVS, will help reduce the incidence of squamous cell carcinoma of the esophagus.
... On gross pathology, esophageal web and esophageal strictures are characteristic findings of PVS. On microscopic histopathological analysis, PVS presents with epithelial atrophy, chronic submucosal inflammation, and epithelial atypia or dysplasia in advanced cases [3][4]. Chronic irritation of the esophagus may predispose to an increased risk of developing esophageal webs or strictures. ...
Plummer-Vinson syndrome (PVS) is characterized by a triad of symptoms comprising microcytic hypochromic anemia, esophageal webs, and dysphagia. PVS is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in males. We report a case of a 39-year-old female patient who had a classic presentation of PVS. PVS is precancerous with high malignant potential; early diagnosis is of utmost importance for better prognosis and surveillance endoscopy is recommended. Iron repletion oftentimes improves the dysphagia; seldom esophageal dilatation is used to provide symptomatic relief.
