INTRAEPITHELIAL HEMORRHAGE OF THE ESOPHAGUS - A TERMINAL EVENT IN HEMATOLOGICAL DISORDERS

Aims-To investigate the clinicopathological findings in cases with int raepithelial haemorrhage of the oesophagus (MO). Methods-Necropsy reco rds and the histopathology findings in the oesophagus were reviewed fo r the period 1990 to 1995. Six cases (0.7%) of MO were found among 919 necropsy cases. Clinical records of these patients and gross and micr oscopic slides were reviewed in detail. Results-The ages of the MO cas es ranged from 42 to 82 years (average 68 years), with a male to femal e ratio of 1:2. All cases had underlying haematological disorders with thrombocytopenia, but disseminated intravascular coagulation was not evident in any case. Macroscopically, solitary (two cases) or multiple (four cases) haemorrhagic lesions ranging from 6 to 79 mm in size wer e identified within the distal oesophagus. Microscopically, there was no inflammatory infiltration, destruction of red blood cells, or submu cosal scar formation. Conclusions-IHO seems to occur shortly before de ath as a terminal event in haematological disorders. Based on these ob servations, the term ''terminal IHO'' can be suggested for this type o f oesophageal lesion.