Difference between revisions of "Gastroesophageal junction"
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m (→In absence of intestinalized mucosa: Sized) |
m (→In absence of intestinalized mucosa: Intra-epithelial) |
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[[File:Histopathology of acute and chronic inflammation of the gastro-esophageal junction, annotated.jpg|thumb|190px|GE junction with chronic inflammation including plasma cells (black arrow), and also an acute inflammation with neutrophils (white arrow).]] | [[File:Histopathology of acute and chronic inflammation of the gastro-esophageal junction, annotated.jpg|thumb|190px|GE junction with chronic inflammation including plasma cells (black arrow), and also an acute inflammation with neutrophils (white arrow).]] | ||
Look for signs of (reflux) '''esophagitis''', mainly:<ref name=PathologyOutlinesEsophagitis>{{cite web|url=http://www.pathologyoutlines.com/topic/esophagusreflux.html|title=Esophagus - Esophagitis - Reflux esophagitis / gastroesophageal reflux disease|author=Elliot Weisenberg}} Topic Completed: 1 October 2012. Minor changes: 8 July 2020</ref> | Look for signs of (reflux) '''esophagitis''', mainly:<ref name=PathologyOutlinesEsophagitis>{{cite web|url=http://www.pathologyoutlines.com/topic/esophagusreflux.html|title=Esophagus - Esophagitis - Reflux esophagitis / gastroesophageal reflux disease|author=Elliot Weisenberg}} Topic Completed: 1 October 2012. Minor changes: 8 July 2020</ref> | ||
− | *'''Inflammatory cells'''. Neutrophils confer a diagnosis of acute inflammation, while plasma cells, eosinophils and excess T cells confer a diagnosis of chronic inflammation. | + | *'''Inflammatory cells''', especially when intra-epithelial. Neutrophils confer a diagnosis of acute inflammation, while plasma cells, eosinophils and excess T cells confer a diagnosis of chronic inflammation. |
*'''Basal cell hyperplasia''' exceeding 15 - 20% of the epithelial thickness. | *'''Basal cell hyperplasia''' exceeding 15 - 20% of the epithelial thickness. | ||
Revision as of 09:44, 7 October 2020
Author:
Mikael Häggström [note 1]
Contents
Microscopic examination
The main finding to look for is intestinalized mucosa (Barret's esophagus), which is defined as the presence of columnar epithelium with goblet cells.[2] A true goblet cell should have rounded shape, clear to bluish cytoplasmic mucin, and be randomly scattered.[3] The mucin usually indents the nucleus.[3]
Further workup of intestinalized mucosa
If intestinalized mucosa (Barret's esophagus) is present, look for dysplasia:
In absence of intestinalized mucosa
Look for signs of (reflux) esophagitis, mainly:[4]
- Inflammatory cells, especially when intra-epithelial. Neutrophils confer a diagnosis of acute inflammation, while plasma cells, eosinophils and excess T cells confer a diagnosis of chronic inflammation.
- Basal cell hyperplasia exceeding 15 - 20% of the epithelial thickness.
Report
Examples:
Gastroesophageal junctional mucosa with chronic inflammation and reactive changes, non-specific. Negative for intestinalized (Barrett's) mucosa. |
Squamous mucosa, negative for significant histopathologic changes. Negative for gastric mucosa or intestinalized (Barrett's) mucosa. |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Riegler, M.; Kristo, I.; Nikolic, M.; Rieder, E.; Schoppmann, S. F. (2017). "Update on the management of Barrett’s esophagus in Austria
". European Surgery 49 (6): 282–287. doi: . ISSN 1682-8631.
- Fig 2- available via license: Creative Commons Attribution 4.0 International - ↑ . Barrett Esophagus. Stanford University School of Medicine. Retrieved on 2020-09-01.
- ↑ 3.0 3.1 Dipti M. Karamchandani. Esophagus - Premalignant - Barrett esophagus. Topic Completed: 19 March 2020, Minor changes: 29 June 2020
- ↑ Elliot Weisenberg. Esophagus - Esophagitis - Reflux esophagitis / gastroesophageal reflux disease. Topic Completed: 1 October 2012. Minor changes: 8 July 2020
Image sources