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Barrett Esophagus : Microscopic

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Barrett esophagus (BE) is defined as replacement of the normal stratified squamous epithelium of the distal esophagus with columnar epithelium containing goblet cells (intestinal metaplasia). Previously, the presence of any one of the three following types of mucosa was sufficient for the diagnosis of BE: 1) cardiac-type mucosa, 2) oxyntic-type mucosa, and 3) specialized intestinal-type mucosa with goblet cells.

Currently, the diagnosis of BE in the United States and Germany requires the presence of specialized Barret mucosa. In Japan, the United Kingdom and most of Europe, the presence of goblet cells is not required for the diagnosis of BE. It is assumed that any columnar mucosa increases the risk of dysplastic and malignant changes.

Image courtesy of: Phoenix Bell, MD.

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