Skip to main content

Histopathology of Early Neoplasia in Barrett’s Esophagus

  • Conference paper
Superficial Esophageal Neoplasm

Abstract

The evolution of early epithelial neoplasia in the lower esophagus occurs in three principal stages. Inflammation and ulceration due to chemical irritation caused by gastroesophageal reflux results in replacement of the squamous epithelium of the lower esophagus by a columnar epithelium showing intestinal differentiation. The columnar epithelial lining, or Barrett’s esophagus, is classified as the long type when the segment is ≥3 cm or the short type when the length is <3 cm. The second stage is the development of focal or multifocal intraepithelial neoplasia (dysplasia) within Barrett’s esophagus. The final stage is the emergence of an invasive (malignant) subclone spreading sequentially into lamina propria, muscularis mucosae, and submucosa. From the diagnostic perspective, critical issues are the diagnosis of Barrett’s esophagus, the distinction between reactive change and unequivocal intraepithelial neoplasia, and the recognition of high-grade intraepithelial neoplasia requiring surgical intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Endo T, Tamaki K, Arimura Y, et al (1998) Expression of sulfated carbohydrate chain and core peptides of mucin detected by monoclonal antibodies in Barrett’s esophagus and esophageal adenocarcinoma. J Gastroenterol 33:811–815

    Article  PubMed  CAS  Google Scholar 

  2. Labouvie C, Machado JC, Carneiro F, et al (1999) Differential expression of mucins and trefoil peptides in native epithelium, Barrett’s metaplasia and squamous cell carcinoma of the oesophagus. J Cancer Res Clin Oncol 125:71–76

    Article  PubMed  CAS  Google Scholar 

  3. Jass JR (1981) Mucin histochemistry of the columnar epithelium of the oesophagus: a retrospective study. J Clin Pathol 34:866–870

    Article  PubMed  CAS  Google Scholar 

  4. Voutilainen M, Färkkilä M, Juhola M, et al (1999) Complete and incomplete intestinal metaplasia at the oesophagogastric junction: prevalences and associations with endoscopic erosive oesophagitis and gastritis. Gut 45:644–648

    Article  PubMed  CAS  Google Scholar 

  5. Takubo K, Nixon JM, Jass JR (1995) Ducts of esophageal glands proper and Paneth cells in Barrett’s esophagus: frequency in biopsy specimens. Pathology 27:315–317

    Article  PubMed  CAS  Google Scholar 

  6. Takubo K, Sasajima K, Yamashita K, et al (1991) Double muscularis mucosae in Barrett’s esophagus. Hum Pathol 22:1158–1161

    Article  PubMed  CAS  Google Scholar 

  7. Eads CA, Lord RV, Kurumboor SK, et al (2000) Fields of aberrant CpG island hypermethylation in Barrett’s esophagus and associated adenocarcinoma. Cancer Res 60:5021–5026

    PubMed  CAS  Google Scholar 

  8. Ormsby AH, Goldblum JR, Rice TW, et al (1999) Cytokeratin subsets can reliably distinguish Barrett’s esophagus from intestinal metaplasia of the stomach. Hum Pathol 30:288–294

    Article  PubMed  CAS  Google Scholar 

  9. Thurberg BL, Duray PH, Odze RD (1999) Polypoid dysplasia in Barrett’s esophagus: a clinicopathologic, immunohistochemical, and molecular study of five cases. Hum Pathol 30:745–752

    Article  PubMed  CAS  Google Scholar 

  10. Schlemper RJ, Itabashi M, Kato Y, et al (1997) Differences in diagnostic criteria for gastric carcinoma between Japanese and Western pathologists. Lancet 349:1725–1729

    Article  PubMed  CAS  Google Scholar 

  11. Lewin KJ, Appelman HD (1996) Atlas of Tumor Pathology. Tumors of the Esophagus and Stomach. AFIP, Washington, DC

    Google Scholar 

  12. Khan S, Do K-A, Kuhnert P, et al (1998) Diagnostic value of p53 immunohistochemistry in Barrett’s esophagus: an endoscopic study. Pathology 30:136–140

    Article  PubMed  CAS  Google Scholar 

  13. Reid BJ, Weinstein WM, Lewin KJ, et al (1988) Endoscopic biopsy can detect high-grade dysplasia or early adenocarcinoma in Barrett’s esophagus without grossly recognizable neoplastic lesions. Gastroenterology 94:81–90

    PubMed  CAS  Google Scholar 

  14. Rubio CA, Riddell R (1988) Musculo-fibrous anomaly in Barrett’s mucosa with dysplasia. Am J Surg Pathol 12:885–889

    Article  PubMed  CAS  Google Scholar 

  15. Schlemper RJ, Kato Y, Stolte M (2000) Diagnostic criteria for gastrointestinal carcinomas in Japan and Western countries: proposal for a new classification system of gastrointestinal epithelial neoplasia. J Gastroenterol Hepatol 15(suppl):C52–C60

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Japan

About this paper

Cite this paper

Jass, J.R. (2002). Histopathology of Early Neoplasia in Barrett’s Esophagus. In: Imamura, M. (eds) Superficial Esophageal Neoplasm. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67873-1_2

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-67873-1_2

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-67997-4

  • Online ISBN: 978-4-431-67873-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics