Clin Endosc.  2014 Jan;47(1):31-39.

Histopathology in Barrett Esophagus and Barrett Esophagus-Related Dysplasia

• Grin A
• Streutker

Abstract

Pathologic specimens, both biopsies and endoscopic mucosal resections, for Barrett esophagus and Barrett-associated dysplasia and malignancy are common for pathologists in North America, and the incidence in South Asian countries seems to be increasing. Dysplasia and malignancy arising in intestinalized gastric-type mucosa raises issues in the interpretation of dysplasia and the evaluation of the depth of invasion of malignancies that are not seen in squamous dysplasia and squamous cell carcinoma. We review the North American approach to these lesions.

Keyword

Barrett esophagus; Endoscopic mucosal resection; Pathology; Dysplasia; Biological markers

MeSH Terms

Asian Continental Ancestry Group
Barrett Esophagus*
Biopsy
Carcinoma, Squamous Cell
Humans
Incidence
Mucous Membrane
North America
Pathology
Biomarkers

Figure

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  Fig. 1 Barrett esophagus-associated dysplasia. (A) Low-grade dysplasia (H&E stain,×50). (B) Indefinite for dysplasia (H&E stain,×100). (C) High-grade dysplasia (H&E stain,×200). (D) Foveolar dysplasia, high grade (H&E stain,×200).

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  Fig. 2 Submucosal invasion of Barrett esophagus-associated adenocarcinoma; association of the tumor with large blood vessels and the presence of early desmoplasia (H&E stain, ×16).

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  Fig. 3 Endoscopic mucosal resection specimen demonstrating duplication of the muscularis mucosae (A, H&E stain, ×16; B, Desmin immunohistochemistry, ×16).

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  Fig. 4 Biomarkers in Barrett esophagus-associated dysplasia. (A) Diffuse strong p53 staining in dysplasia (×200). (B) Ki-67 staining showing surface mitotic activity in dysplasia (×100).

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