Barrett esophagus is a pre-malignant condition. It is important to look for dysplasia when Barrett esophagus is diagnosed. Dysplastic changes consist of both cytologic as well as architectural atypia. Cytologic changes include nuclear hyperchromasia and stratification, irregularly clumped chromatin, increased N:C ratios, increased mitotic activity including abnormal mitotic figures, and loss of polarity. The image shows low-grade dysplasia.