Esophageal Pyogenic Granuloma: Endosonographic Findings and Endoscopic Treatments
A 54-year-old man visited our hospital because of the incidental detection of a polypoid lesion in the esophagus during a medical check-up. The patient was asymptomatic, and abnormalities were not found during his physical and laboratory examinations. The upper endoscopy showed a 0.5-cm reddish polypoid lesion located 30 cm from the incisor teeth (). This lesion was covered by some exudates and did not exhibit the cushion sign. EUS showed that the lesion was homogeneously hyperechogenic, had clear margins, and was located in the lamina propria (). It was suspected as a pyogenic granuloma. After forceps biopsy, a moderate amount of bleeding occurred. The bleeding was stopped by epinephrine injection. The result of endoscopic biopsy revealed capillary hemangioma. EMR was performed using a ligation device (). Histological analysis showed that the resected polyp was composed of abundant capillaries that were lined with endothelial cells (); the polyp was infiltrated with acute and chronic inflammatory cells. The histological features were consistent with those of pyogenic granuloma. Recurrence was not observed during the follow-up endoscopy performed 6 months later.