| Theme |
Guidebook of Pathology for Gastroenterologists and Hepatologists ; Including Special Stains and Immunohistochemistry |
| Title |
Histopathological Diagnosis of Barrett's Esophagus and Barrett's Adenocarcinoma |
| Author |
Hiroshi Kawachi |
Department of Pathology, Tokyo Medical and Dental University Graduate School |
| Author |
Tatsuyuki Kawano |
Department of Esophagogastric Surgery, Tokyo Medical and Dental University Graduate School |
| [ Summary ] |
Columnar epithelia in Barrett's esophagus are classified into three types : (1) fundic gland mucosa-type (gastric corpus mucosa-type) epithelia ; (2) cardiac gland mucosa-type (pseudo pyloric gland mucosa-type, transitional type) ; (3) intestinal metaplasia-type (specialized columnar epithelia). Furthermore, the histological characters other than epithelia in Barrett's esophagus are (1) proper esophageal glands under the columnar epithelium, (2) squamous islands in the columnar epithelial area, (3) double layer structures of muscularis mucosa. For the histopathological diagnosis of Barrett's adenocarcinoma, it is necessary to confirm that cancer lesions are surrounded by Barrett's epithelia. However, it is sometimes difficult to find conclusive evidence of Barrett's adenocarcinoma, especially when biopsy or mucosectomy specimens were examined. Therefore, it is also important to evaluate not only by the histological findings but by the endoscpopical and radiological findings. |