Clinical Gastroenterology Vol.22 No.1(2)

Theme Barrett's Esophagus
Title Pathological Aspects of Barrett's Esophagus
Publish Date 2007/01
Author Kaiyo Takubo Research Team for Geriatric Diseases, Tokyo Metropolitan Institute of Gerontology
Author Junko Aida Research Team for Geriatric Diseases, Tokyo Metropolitan Institute of Gerontology
Author Naoko Honma Research Team for Geriatric Diseases, Tokyo Metropolitan Institute of Gerontology
Author Katsuhiko Iwakiri 3rd Department of Internal Medicine, Nippon Medical School
Author Motoji Sawabe Department of Pathology, Tokyo Metropolitan Geriatric Medical Center
Author Tomio Arai Department of Pathology, Tokyo Metropolitan Geriatric Medical Center
[ Summary ] The pathological aspects of Barrett's esophagus were reviewed. The borderline between the esophagus and stomach has been defined as the distal limit of the longitudinal vessels by the Japan Esophageal Society, because the longitudinal vessels are always located within the esophagus. Histologically, we may consider diagnosis of Barrett's mucosa when biopsied specimens of the mucosa proximal to the longitudinal vessels reveal columnar lined mucosa. As squamous islands in Barrett's mucosa are usually the orifices of esophageal glands proper, biopsy specimens from the squamous islands show esophageal glands proper or their ducts. The identification of esophageal glands proper, or their ducts, is a definite histological indicator that a piece of biopsy tissue is of esophageal origin. A diagnosis of Barrett's esophagus can be made purely on the basis of the histologic findings in these biopsy specimens of squamous island tissue. However, since both longitudinal vessels and the columnar mucosa are usually recognizable with endoscopy, a diagnosis of Barrett's esophagus can be made solely on the basis of endoscopic examination, without any need for histologic confirmation.
back