Barrett's Esophagus - BPA Pathology

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Barrett’s <strong>Esophagus</strong>:Metaplasia and Dysplasia1. Metaplasia - Def’n/types- Pathogenesis- Differential Diagnosis2. Dysplasia - Incidence/risk factors- Pathologic Features- Adjunctive Diagnostic tests- Natural History- Treatment
Barrett’s <strong>Esophagus</strong>Definition• Columnar metaplasia ofesophageal squamous epithelium(any length)• Recognized at endoscopy• Goblet cell metaplasia
Page 1: Surgical Pathology and CurrentMolec
Page 5: Barrett’s EsophagusEpithelial Typ
Page 10: Multilayered Epithelium
Page 16: Short (Ultrashort) BE vs.Chronic Ca
Page 26 and 27: Esophageal versus Cardia___________
Page 28 and 29: Barrett’s Dysplasia/CarcinomaRisk
Page 30 and 31: Barrett’s Dysplasia/CarcinomaRisk
Page 32 and 33: DysplasiaPathologic Features1. Gros
Page 34: Non-Recommended Terms“Atypia”
Page 65 and 66:
Barrett’s-related DysplasiaIntero
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Adjunctive TechniquesProliferation
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Esophagectomy forHigh-Grade Dysplas
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ACG guidelines for Surveillance in
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Management ConsiderationsSurveillan
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Molecular Basis ofBarrett’s Esoph
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Non-DysplasticBarrett’s Esophagus
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Aneuploidy Predicts Progressionin B
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p53 Gene Detection•17p loss of he
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17p LOH & Progressionin Barrett’s
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p53 “Positive” Immunostaining
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p53 Positive Barrett’s Indefinite
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Detection of p16 Inactivationin Bar
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Cyclin D1 Gene•Cyclin/CDK complex
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Molecular Summary ofBarrett’s Eso
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Molecular Summary ofBarrett’s Eso
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Dysplasia in Crohn’s Disease• R
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Dysplasia in Crohn’s Disease(Sige
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Risk of Neoplasia in UC1. Dysplasia
Page 104 and 105:
Primary Sclerosing CholangitisRisk
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UC-Associated DysplasiaInterobserve
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Flat DysplasiaNatural History(Berns
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Colectomy for Low Grade Dysplasia__
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DALMAdenoma LikeSessile/Pedunculate
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Adenoma vs Polypoid Dysplasia1. Mor
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Adenoma vs Polypoid DysplasiaValue
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Genetic Alterations inChronic ulcer
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Is it possible to reliablydifferent
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______Feature CUC patients Non-CUCA
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Rubin et al________________________
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DALMAdenoma-likeNon-Adenoma-like(br
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Genetic Progression inColitis-Assoc
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Colitis-AssociatedVersus Sporadic N
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Aneuploidy Associations inColitis-A
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neuploidy Predicts Progressionin No
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p53 inNegative/IndefiniteMucosa
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Other Markers inColitis-Associated
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Chromosomal Instability (CIN)in Col
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Telomere Erosion inColitis-Associat
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Fecal DNA Mutation Testing•High s
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Squamous Dysplasia
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Squamous dysplasiaclinical features
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Pathologic features• Gross: eryth
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Squamous dysplasia vs reactiveFeatu
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Squamous dysplasia- treatmentDYSPLA
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Genetic Progression inEsophageal Sq
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p53 Immunostaining inEsophageal Squ
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Small Intestinal Metaplasia andDysp
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Mucous cell metaplasia• Feature o
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Small intestinal dysplasia• Crohn
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Gastric Metaplasia and Dysplasia
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Gastric carcinomarisk factors•
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Intestinal metaplasiaclassification
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Gastric dysplasiaPadova classificat
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Gastric dysplasia-differentialdiagn
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Gastric DysplasiaManagementLOW GRAD
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Gastric hyperplastic polyps• Most
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Fundic gland polypsClinical feature
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Molecular Basis ofGastric Dysplasia
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p53 Alterations in GastricMetaplasi
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MSH2MSH3DNA mismatchmismatch bindin
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Mismatch Repair Gene Immunohistoche
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MLH1 Methylation inGastric Metaplas
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Fundic Gland Polyps•Occur in two
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Genetic Predictors of Dysplasiain F
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Barrett's Esophagus - BPA Pathology

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