Heterotopic Gastric Mucosa in the Upper Esophagus: Report of a Case with Adenoma

Abstract

The inlet patch is a congenital anomaly consisting of heterotopic gastric mucosa (HGM) most commonly located in the postcricoid portion of the esophagus at or just below, the level of the upper esophageal sphincter. Foci of HGM have been identified at different sites in the human body, including the head and neck, gastrointestinal tract, hepatobiliary system, and genital system, but the most common location in the proximal esophagus, which is referred to as cervical inlet patch (CIP). The presence of a HGM in the upper esophagus is an infrequent disorder. The most common histological subtype of CIP is the fundic mucosa (gastric body type with oxyntic glands, acid-secreting parietal and chief cells) followed by cardia-type mucosa. The true prevalence of CIP varies and it is usually incidental finding during endoscopy because CIP is always asymptomatic. The CIP is usually found at between 15 and 21 sm from the bite guard and on standard endoscopy it is found as a reddish or salmon-rose colored focal area and in the narrow band imaging mode it is look like as a homogeneous dark brown lesion, which is distinctly separated from the light green squamous epithelium, and the patch may be variable in size and in shaped (oval, round or even geographical), rarely may appear as a protrusive or polypoid lesion.