A clinical and histopathologic focus on Barrett esophagus and Barrett-related dysplasia.

Abstract:

CONTEXT:Barrett esophagus is a metaplastic, premalignant lesion associated with approximately 0.5% annual incidence of progression to esophageal adenocarcinoma. Diagnosis and screening of Barrett esophagus and Barrett-related dysplasia relies on histologic evaluation of endoscopic mucosal biopsies, a process that is burdened with interobserver variability. OBJECTIVES:To review the histologic features and classification of Barrett esophagus and Barrett-related dysplasia, to discuss the underlying difficulties in diagnosis and pitfalls, and to provide a brief review of new developments related to therapeutic modalities for patients diagnosed with dysplasia. DATA SOURCES:Sources include a review of relevant literature indexed in PubMed (US National Library of Medicine). CONCLUSIONS:In spite of interobserver variability, histologic assessment of dysplasia is currently the accepted method of surveillance, and subsequent patient management is dictated by this evaluation. Although not universal, endoscopic therapy is increasingly important in replacing esophagectomy for patients with high-grade dysplasia or early carcinoma.

journal_name

Arch Pathol Lab Med

authors

Voltaggio L,Montgomery EA,Lam-Himlin D

doi

10.5858/arpa.2011-0019-RA

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

1249-60

issue

10

eissn

0003-9985

issn

1543-2165

journal_volume

135

pub_type

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