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Barrett Esophagus : Intramucosal CA

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Intramucosal Carcinoma in Barrett Esophagus (BE): Intramucosal carcinoma in BE is defined as adenocarcinoma invading through the basement membrane into lamina propria or muscularis mucosa but not beyond; i.e. submucosa is not invaded.

It usually consists of crowded microglands, syncytial cords of dysplastic cells, or even single cells infiltrating into the lamina propria. Desmoplastic response is minimal or absent in these early lesions.

Unlike colon where lamina propria lacks significant lymphatics, the lamina propria in esophagus has a rich lymphatic network and therefore intramucosal carcinoma carries metastatic potential.

Like high-grade dysplasia, intramucosal carcinoma in BE can be treated with endoscopic ablative therapies (photoablation, cryoablation, radiofrequency ablation) or resection techniques such as endoscopic mucosal resection and endoscopic submucosal dissection.

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