An erosion in the squamous epithelium of the esophagus can be seen, along with brown foreign material.
Although difficult to see, the foreign brown material (representing iron) is deposited in the lamina propria as well as epithelium.
An iron stain confirms the identify of this foreign brown material.
The esophagus can often be damaged when pills adhere to the mucosal wall and release their contents (when taken with little or no water). In this particular case, the patient ingested iron pills. On endoscopy, one can see discrete ulceration, most commonly at the level of the aortic arch. Microscopically, there are nonspecific erosions and ulcerations. Sometimes, brown material representing iron deposits can be seen.
Manifests as sudden onset of retrosternal pain and odynophagia.
Case is contributed by Dr. Kate Sciandra, Dept of Pathology, VAMC Albuquerque New Mexico.