Barrett Esophagus : Microscopic
Barrett esophagus (BE) frequently shows duplication of the muscularis mucosae (MM) in which a new more superficial MM layer forms at the base of the crypts and is separated from the true MM by edematous lamina propria. It is important to recognize duplicated MM in cases with invasive EAC, as patients with MM invasion have increased rates of lymph node metastasis. Recently, multilayered epithelium (MLE) has been proposed as the potential precursor of intestinal metaplasia. MLE shows columnar epithelium at the top overlying squamous cells at the basal surface. MLE is frequently seen in patients with GERD. Image courtesy of: Phoenix Bell, MD.