Severe destruction of esophageal nerves in a patient with achalasia secondary to gastric cancer: a possible role of eosinophil neurotoxic proteins

We present a case of secondary achalasia due to an adenocarcinoma of the stomach with no tumor infiltration of the esophagus. Immunohistochemical staining revealed a massive infiltration of activated eosinophils in the muscularis of the esophagus with secretion of the highly cytotoxic and neurotoxic...

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Bibliographic Details
Published in:Digestive diseases and sciences 1989-02, Vol.34 (2), p.297-303
Main Authors: FREDENS, K, TØTTRUP, A, KRISTENSEN, I. B, DAHL, R, JACOBSEN, N. O, FUNCH-JENSEN, P, THOMMESEN, P
Format: Article
Language:English
Subjects:
Adenocarcinoma - complications
Adenocarcinoma - pathology
Aged
Biological and medical sciences
Blood Proteins - analysis
Eosinophil Granule Proteins
Esophageal Achalasia - etiology
Esophageal Achalasia - metabolism
Esophageal Achalasia - pathology
Esophagus - analysis
Esophagus - innervation
Esophagus - pathology
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Immunohistochemistry
Male
Medical sciences
Nerve Fibers - pathology
Ribonucleases
Stomach Neoplasms - complications
Stomach Neoplasms - pathology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Substance P - analysis
Tumors
Vasoactive Intestinal Peptide - analysis
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Summary:We present a case of secondary achalasia due to an adenocarcinoma of the stomach with no tumor infiltration of the esophagus. Immunohistochemical staining revealed a massive infiltration of activated eosinophils in the muscularis of the esophagus with secretion of the highly cytotoxic and neurotoxic eosinophil cationic protein (ECP). Immunohistochemical staining for the neuropeptides VIP and substance P, as well as the histochemical demonstration of AChE, revealed a nearly total absence of all three neurotransmitters/modulators compared to control. The hypothesis is advanced that eosinophil neurotoxicity is the cause of secondary achalasia.
ISSN:0163-2116
1573-2568
DOI:10.1007/BF01536066