Esophagus, Barrett's esophagus [LMP48698]

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Image Details
Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Tissue Renewal, Regeneration, and Repair
Diagnosis: 
Barrett's esophagus
Species: 
Human
Organ System: 
Gastrointestinal Tract
Gender: 
Male
Age: 
61 years
Diagnosis Code: 
ICD-10: K22.7
Slide Contributor Information
Riddell, R., Nanji, S., Chang, M.

Keywords

Barrett, intestinal metaplasia, proton pump inhibitor.

Clinical History

Patient with gastro-esophageal reflux disease and a history of proton pump inhibitor treatment. Biopsies were taken near the esophageal-gastric junction of an area of unspecified endoscopic appearance.

Clinical Discussion

Barrett's esophagus occurs when there is reactive metaplasia in the squamous mucosa of the distal esophagus in response to chronic injury. The most important feature is to recognize the intestinal metaplasia, and that it is not dysplastic. The diagnosis of Barrett’s esophagus needs both the presence of an endoscopic abnormality consistent with Barrett’s mucosa and the presence of intestinal metaplasia on biopsy. If the endoscopy was normal (normal Z-line) then these changes are those of intestinal metaplasia in the cardia. Current guidelines suggest this needs no further follow-up, mainly because it is so common in the population in which 20-35% of Z-lines have this change if multiple biopsies are taken. In this section, focal pancreatic-type metaplasia is also seen (of unknown significance).