Overlap of reflux and eosinophilic esophagitis in two patients requiring different therapies: A review of the literature

Figure 2 Case 2. A: Endoscopic view of the upper esophagus showing multiple concentric rings resembling mucosal undulations; B: Endoscopic picture of a peptic stricture at cardias 2 mo after dilation, with gentle pressure of the endoscope; C: Biopsies of a multiringed esophagus demonstrating severe lamina propia fibrosis at the bottom of the image, as well as marked papillae elongation and basal zone hyperplasia (HE, × 100). In the upper right box, intense intercellular edema, basal zone hyperplasia and dense eosinophilic infiltrate (37eo/ HPF, × 400) towards the surface strata (HE, × 200); D: Persistent histopathologic features (32 eo/HPF, × 400) in spite of effective PPI therapy, as shown by 24 h pH esophageal monitoring (box).