[Pathology of non-reflux esophagitides]

The topic of non-reflux esophagitides is partially hidden in the shadow cast by the huge and modern entity of gastroesophageal reflux disease. Histological investigation alone is often insufficient to reach the correct diagnosis without a correlation of the microscopic picture with clinical presentation, endoscopic gross appearance, personal and pharmacological history of the patient, results of hematological, serological, immunological and microbiological examinations. Due to their low-prevalence, individual types of non-reflux esophagitides are not routinely encountered in routine biopsies. Furthermore, the plethora of etiological agents present with only a limited range of reaction patterns, and thus a single histological picture may be common for more agents. Conversely, one cause may be associated with more morphological patterns. Due to these circumstances the pathological diagnostic management should follow a settled algorithm to prevent an inadequate narrowing of the histopathologist´s view. Histologic findings forming the base of this algorithm include distribution and type of inflammatory infiltrate, appearance of epithelial changes, and (in some cases) even the presence of causative agent in histological slides.