Civatte Bodies in Pediatric Esophageal Biopsies: Does Lichen Esophagitis Pattern Occur in Children?

Area of Science:

• Gastroenterology
• Pediatric Pathology
• Dermatology

Background:

• Civatte bodies (CB) are linked to lichen planus in adults.
• Lichen planus and Lichen Esophagitis Pattern are not well-described in pediatric populations.
• Understanding esophageal CB in children is crucial for accurate diagnosis.

Purpose of the Study:

• To characterize clinicopathologic associations of esophageal Civatte bodies (CB) in pediatric patients.
• To determine the occurrence of lichen planus or Lichen Esophagitis Pattern in children.
• To highlight the under-recognition of pediatric esophageal CB.

Main Methods:

• Retrospective review of pediatric esophageal biopsy records.
• Inclusion criteria: diagnoses containing "CB," "apoptosis," "necrosis," or "dyskeratosis."
• Exclusion criteria: concurrent eosinophilic/acute esophagitis; review of H&E slides and clinical reports.

Main Results:

• Identified CB in 19 pediatric patients; 8 cases termed "dyskeratotic cells."
• Patients showed male predominance (74%) and frequent comorbidities (polypharmacy, Crohn, celiac disease).
• CB were predominantly in the distal esophagus (95%), often isolated (63%), with variable inflammation.

Conclusions:

• Pediatric esophageal CB are under-recognized and may present differently than in adults.
• Features and clinical implications of pediatric esophageal CB require further investigation.
• Documentation of pediatric esophageal CB is essential for understanding their significance.