Esophagitis with an inflammatory polyp. (Esophagoscopy Clinic).

A 46-year-old woman came to us with a history of hoarseness, globus pharyngeus, and heartburn. She had been previously treated with an [H.sub.2] blocker, which had provided some relief. She underwent transnasal esophagoscopy (TNE) as a component of her evaluation, and it revealed a linear erosion of the distal third of the esophagus (figure, A and B). The erosion terminated on a smooth, well-mucosalized mass located adjacent to the gastroesophageal junction. Biopsy analyses of the mass revealed inflammatory changes that were consistent with a reflux-induced inflammatory polyp.

We also evaluated another patient, a 39-year-old man, who had a known history of gastroesophageal reflux disease (GERD) in addition to vocal symptoms. This patient also underwent TNE, which detected several inflamed and enlarged gastric folds at the gastroesophageal junction (figure, C).

Inflammatory polyps are the most common polypoid lesions of the esophagus. They often occur in combination with other sequelae of GERD, such as esophagitis. Less often, an enlarged gastric fold near the squamocolumnar junction, also called the sentinel fold, is seen in reflux esophagitis. Inflammatory polyps should be differentiated from neoplasms by biopsy.

From the Center for Voice Disorders, Department of Otolaryngology, Wake Forest University Medical Center, Winston-Salem, N.C.; www.thevoicecenter.org