| Theme |
Diagnosis and Treatment of Barrett's Esophagus : up-to-date |
| Title |
Histopathologic Diagnostic Criteria and Pathognomonic Features of Barrett's Esophagus |
| Author |
Junko Aida |
Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology |
| Author |
Makoto Nishimura |
Department of Endoscopy, Tokyo Metropolitan Geriatric Hospital |
| Author |
Yoshio Hoshihara |
Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology |
| Author |
Tomio Arai |
Department of Pathology, Tokyo Metropolitan Geriatric Hospital |
| Author |
Kaiyo Takubo |
Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology |
| [ Summary ] |
Histopathologic diagnosis of Barrett's esophagus (BE) is difficult for two reasons. The first is the histologic similarity of BE to gastric fundic mucosa with or without intestinal metaplasia. The second is that endoscopically resected specimens include only mucosa. For accurate histopathologic diagnosis of BE, it is essential for pathologists to have sufficient knowledge of the pathognomonic features of the esophagogastric junction (EGJ) and the lower esophagus. Because the definitions of the EGJ and BE used in Japan differ from those used in Western countries, there are two points to note in relation to the histopathologic diagnosis of BE. The first is that it is not necessary to search for intestinal metaplasia. The second is that palisade veins can be used as a histologic marker of the lower esophagus. For histopathologic diagnosis of BE, there are four histologic markers observed in the lower esophagus : A. esophageal glands proper and their ducts, B. squamous islands, C. palisading veins, and D. duplication of the muscularis mucosae. However, the most important consideration for accurate diagnosis is communication between clinicians and pathologists with regard to the precise location or features of the lesions or biopsied areas, and also the points at issue. |