Gastroesophageal junction: Difference between revisions
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If intestinalized mucosa (Barret's esophagus) is present, look for dysplasia: | If intestinalized mucosa (Barret's esophagus) is present, look for dysplasia: | ||
<gallery mode=packed heights=200> | <gallery mode=packed heights=200> | ||
File:Barrett's mucosa, low-grade dysplasia.jpg|Low-grade dysplasia: Simple straight but elongated tubules lined by dysplastic cells. | File:Barrett's mucosa, low-grade dysplasia.jpg|'''Low-grade dysplasia''': Simple straight but elongated tubules lined by dysplastic cells. | ||
File:Barrett's mucosa, low-grade dysplasia, low-power view, H&E.jpg|Low-grade dysplasia: Elongated tubules crowded together. | File:Barrett's mucosa, low-grade dysplasia, low-power view, H&E.jpg|'''Low-grade dysplasia''': Elongated tubules crowded together. | ||
File:Barrett's mucosa, low-grade dysplasia, H&E.jpg|Low-grade dysplasia: Crowded glandular profiles lined by atypical cuboidal cells. These contain basally oriented, enlarged vesicular nuclei and prominent nucleoli. | File:Barrett's mucosa, low-grade dysplasia, H&E.jpg|'''Low-grade dysplasia''': Crowded glandular profiles lined by atypical cuboidal cells. These contain basally oriented, enlarged vesicular nuclei and prominent nucleoli. | ||
File:Barrett's mucosa, low-grade dysplasia, high-power magnification.jpg|Low-grade dysplasia: Pseudostratified epithelium, with hyperchromatic elongated nuclei occupying much of the cells. | File:Barrett's mucosa, low-grade dysplasia, high-power magnification.jpg|'''Low-grade dysplasia''': Pseudostratified epithelium, with hyperchromatic elongated nuclei occupying much of the cells. | ||
File:Barrett's mucosa, high-grade dysplasia, high-power magnification, H&E.jpg|High-grade dysplasia: The cells are cuboidal and the nuclei have lost their normal basal polarity. | File:Barrett's mucosa, high-grade dysplasia, high-power magnification, H&E.jpg|'''High-grade dysplasia''': The cells are cuboidal and the nuclei have lost their normal basal polarity. | ||
File:Barrett's mucosa, high-grade dysplasia.jpg|High-grade dysplasia: highly dysplastic cells | File:Barrett's mucosa, high-grade dysplasia.jpg|'''High-grade dysplasia''': highly dysplastic cells | ||
File:Histopathology of esophageal carcinoma.jpg|Esophageal adenocarcinoma | File:Histopathology of esophageal carcinoma.jpg|Esophageal '''adenocarcinoma''' | ||
</gallery> | </gallery> | ||
Revision as of 18:19, 28 September 2020
Author:
Mikael Häggström [note 1]
Microscopic examination
The main finding to look for is intestinalized mucosa (Barret's esophagus), which is defined as the presence of columnar epithelium with goblet cells.[2] A true goblet cell should have rounded shape, clear to bluish cytoplasmic mucin, and be randomly scattered.[3] The mucin usually indents the nucleus.[3]
Further workup of intestinalized mucosa
If intestinalized mucosa (Barret's esophagus) is present, look for dysplasia:
-
Low-grade dysplasia: Simple straight but elongated tubules lined by dysplastic cells.
-
Low-grade dysplasia: Elongated tubules crowded together.
-
Low-grade dysplasia: Crowded glandular profiles lined by atypical cuboidal cells. These contain basally oriented, enlarged vesicular nuclei and prominent nucleoli.
-
Low-grade dysplasia: Pseudostratified epithelium, with hyperchromatic elongated nuclei occupying much of the cells.
-
High-grade dysplasia: The cells are cuboidal and the nuclei have lost their normal basal polarity.
-
High-grade dysplasia: highly dysplastic cells
-
Esophageal adenocarcinoma
Report
Examples:
| Gastroesophageal junctional mucosa with chronic inflammation and reactive changes, non-specific. Negative for intestinalized (Barrett's) mucosa. |
| Squamous mucosa, negative for significant histopathologic changes. Negative for gastric mucosa or intestinalized (Barrett's) mucosa. |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Riegler, M.; Kristo, I.; Nikolic, M.; Rieder, E.; Schoppmann, S. F. (2017). "Update on the management of Barrett’s esophagus in Austria
". European Surgery 49 (6): 282–287. doi:. ISSN 1682-8631.
- Fig 2- available via license: Creative Commons Attribution 4.0 International - ↑ . Barrett Esophagus. Stanford University School of Medicine. Retrieved on 2020-09-01.
- ↑ 3.0 3.1 Dipti M. Karamchandani. Esophagus - Premalignant - Barrett esophagus. Topic Completed: 19 March 2020, Minor changes: 29 June 2020
Image sources