Gastroesophageal junction
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.[1] A true goblet cell should have rounded shape, clear to bluish cytoplasmic mucin, and be randomly scattered.[2] The mucin usually indents the nucleus.[2]
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
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
- ↑ . Barrett Esophagus. Stanford University School of Medicine. Retrieved on 2020-09-01.
- ↑ 2.0 2.1 Dipti M. Karamchandani. Esophagus - Premalignant - Barrett esophagus. Topic Completed: 19 March 2020, Minor changes: 29 June 2020
Image sources