Wednesday, December 15, 2010

Barrett esophagus.


replacement of the normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells

Prolonged and recurrent gastroesophageal reflux causes inflammation and eventually ulceration of the squamous epithelial lining. Healing occurs by ingrowth of progenitor cells and re-epithelialization by metaplastic columnar epithelium, thought to be more resistant absorptive enterocytes are not observedUlcer and stricture can occur,

30- to 100-fold greater risk of developing esophageal adenocarcinoma, hence, periodic screening for high-grade dysplasia with esophageal biopsy is recommended, and surgery or photodynamic ablation may need to be done.

salmon-pink, velvety mucosa between the smooth, pale-pink esophageal squamous mucosa and the more lush light brown gastric mucosa

Tongues extending up from the gastroesophageal junction, as an irregular circumferential band displacing the squamocolumnar junction cephalad, or as isolated patches (islands) in the distal esophagus

Squamous epithelium is replaced by metaplastic columnar epithelium
recognition of dysplastic changes in the mucosa that may be precursors of cancer is important.

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