The following diagnostic categories are used in the context of Barrett esophagus (BE).
Negative for Dysplasia
- Negative for Dysplasia
- Indefinite for Dysplasia
- Positive for Low-grade Dysplasia
- Positive for High-grade Dysplasia
- Intramucosal Carcinoma
: This image shows BE, negative for dysplasia. There is normal surface maturation
from the basal glands to the top. The nuclei in the basal portion are slightly larger and more hyperchromatic than those at the surface. Overall, there is no cytologic atypia
. The nuclei have smooth contours. Nucleoli are not enlarged. Nuclear polarity
throughout the glands. Some degree of nuclear stratification, a few mitoses in the basal glands, and a few dysmorphic goblet cells are acceptable. The glandular architecture
. There is abundant lamina propria
separating the glands (i.e. no overcrowding). In the presence of ulceration, erosion, or acute inflammation, there may be reparative changes. The nuclei may become enlarged and hyperchromatic with prominent nucleoli, but should still maintain smooth contours. Surface maturation should be normal. There may be some loss of surface mucin.