Question

Describe the histological changes that occur in patients with Zollinger-Ellison Syndrome. What is the etiology of the disorder? How does the etiology of this disorder differ from that of gastroesophageal reflex disease? What protective mechanisms does the tissue employ to prevent the tissue damage observed in disorders mentioned above?

Answer 1

Zollinger Ellison syndrome is due to the excess secretion of gastrin from other sites than stomach. In this disorder, there found to be gastrin secreting tumours (gastrinomas) are found in organs like the pancreas and intestines. This excess levels of gastrin will causes more acid release into the stomach.

In gastroesophageal reflux disease, there is loss of tone of the lower esophageal sphincter, there by acid can reflux back into the esophagus.

So in order to sustain the acid damage, the stratified squamous epithelium of the esophagus is replaced by the columnar epithelium as it can sustain the acid damage... This is a form of metaplasia and is often called as Barrets esophagus.

So in zollinger Ellison syndrome, the increased levels of gastrin will cause histological changes like that of the increased number of parietal cells to cause increased acid production. There are relatively normal to low number of cheif cells and other mucous cells.