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. 1986 Sep;27(9):1062–1068. doi: 10.1136/gut.27.9.1062

Histological and histochemical changes in the columnar lined (Barrett's) oesophagus.

G A Rothery, J E Patterson, C J Stoddard, D W Day
PMCID: PMC1433804  PMID: 3758820

Abstract

Multiple endoscopic specimens were obtained from 58 patients with a columnar lined gesophagus to study the histological and histochemical features of this metaplastic epithelium. Five patients (8.6%) had presented with a primary oesophageal adenocarcinoma. Three different epithelial types, junctional, atrophic fundic and intestinal were identified. Twenty two (38%) patients had just one type of epithelium present, the other 36 (62%) having a combination of two or three different types. Intestinal type of epithelium, either alone or in combination with gastric type epithelium was present in 48 (83%) patients. In every case this intestinal type epithelium took the form of an incompletely differentiated variant of intestinal metaplasia, although complete intestinal metaplasia as a focal change was also present in 14 of these patients. Histochemically, sulphomucins were present in the biopsies of 43 (74%) of the patients studied. They were seen in both goblet and columnar mucous cells with almost equal frequency. Incomplete intestinal metaplasia with sulphomucin production was present in four of the five patients with an oesophageal adenocarcinoma. In the columnar lined oesophagus sulphomucin production is common and its presence does not help to identify those individuals at particular risk of developing an adenocarcinoma.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADLER R. H. The lower esophagus lined by columnar epithelium. Its association with hiatal hernia, ulcer, stricture, and tumor. J Thorac Cardiovasc Surg. 1963 Jan;45:13–34. [PubMed] [Google Scholar]
  2. ALLISON P. R., JOHNSTONE A. S. The oesophagus lined with gastric mucous membrane. Thorax. 1953 Jun;8(2):87–101. doi: 10.1136/thx.8.2.87. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BARRETT N. R. Chronic peptic ulcer of the oesophagus and 'oesophagitis'. Br J Surg. 1950 Oct;38(150):175–182. doi: 10.1002/bjs.18003815005. [DOI] [PubMed] [Google Scholar]
  4. Berenson M. M., Herbst J. J., Freston J. W. Enzyme and ultrastructural characteristics of esophageal columnar epithelium. Am J Dig Dis. 1974 Oct;19(10):895–907. doi: 10.1007/BF01076212. [DOI] [PubMed] [Google Scholar]
  5. Berenson M. M., Riddell R. H., Skinner D. B., Freston J. W. Malignant transformation of esophageal columnar epithelium. Cancer. 1978 Feb;41(2):554–561. doi: 10.1002/1097-0142(197802)41:2<554::aid-cncr2820410223>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  6. Bezahler G. H. Mucosal patterns in Barrett's metaplasia. Hum Pathol. 1983 Dec;14(12):1093–1093. doi: 10.1016/s0046-8177(83)80271-8. [DOI] [PubMed] [Google Scholar]
  7. DELAPAVA S., PICKREN J. W., ADLER R. H. ECTOPIC GASTRIC MUCOSA OF THE ESOPHAGUS. A STUDY ON HISTOGENESIS. N Y State J Med. 1964 Jul 15;64:1831–1835. [PubMed] [Google Scholar]
  8. Dahms B. B., Rothstein F. C. Barrett's esophagus in children: a consequence of chronic gastroesophageal reflux. Gastroenterology. 1984 Feb;86(2):318–323. [PubMed] [Google Scholar]
  9. Dayal Y., Wolfe H. J. Gastrin-producing cells in ectopic gastric mucosa of developmental and metaplastic origins. Gastroenterology. 1978 Oct;75(4):655–660. [PubMed] [Google Scholar]
  10. GOLDMAN M. C., BECKMAN R. C. Barrett syndrome. Case report with discussion about concepts of pathogenesis. Gastroenterology. 1960 Jul;39:104–110. [PubMed] [Google Scholar]
  11. Goldman H., Antonioli D. A. Mucosal biopsy of the esophagus, stomach, and proximal duodenum. Hum Pathol. 1982 May;13(5):423–448. doi: 10.1016/s0046-8177(82)80026-9. [DOI] [PubMed] [Google Scholar]
  12. Goldman H., Ming S. C. Fine structure of intestinal metaplasia and adenocarcinoma of the human stomach. Lab Invest. 1968 Feb;18(2):203–210. [PubMed] [Google Scholar]
  13. Hage E., Pedersen S. A. Morphological characteristics of the columnar epithelium lining the lower oesophagus in patients with Barrett's syndrome. Virchows Arch A Pathol Pathol Anat. 1972;357(3):219–229. doi: 10.1007/BF00542849. [DOI] [PubMed] [Google Scholar]
  14. Haggitt R. C., Tryzelaar J., Ellis F. H., Colcher H. Adenocarcinoma complicating columnar epithelium-lined (Barrett's) esophagus. Am J Clin Pathol. 1978 Jul;70(1):1–5. doi: 10.1093/ajcp/70.1.1. [DOI] [PubMed] [Google Scholar]
  15. Hamilton S. R., Yardley J. H. Regnerative of cardiac type mucosa and acquisition of Barrett mucosa after esophagogastrostomy. Gastroenterology. 1977 Apr;72(4 Pt 1):669–675. [PubMed] [Google Scholar]
  16. Jass J. R. Mucin histochemistry of the columnar epithelium of the oesophagus: a retrospective study. J Clin Pathol. 1981 Aug;34(8):866–870. doi: 10.1136/jcp.34.8.866. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Jass J. R. Role of intestinal metaplasia in the histogenesis of gastric carcinoma. J Clin Pathol. 1980 Sep;33(9):801–810. doi: 10.1136/jcp.33.9.801. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Jass J. R., Strudley I., Faludy J. Histochemistry of epithelial metaplasia and dysplasia in human stomach and colorectum. Scand J Gastroenterol Suppl. 1984;104:109–130. [PubMed] [Google Scholar]
  19. Lee R. G. Mucins in Barrett's esophagus: a histochemical study. Am J Clin Pathol. 1984 Apr;81(4):500–503. doi: 10.1093/ajcp/81.4.500. [DOI] [PubMed] [Google Scholar]
  20. Lei D. N., Yu J. Y. Types of mucosal metaplasia in relation to the histogenesis of gastric carcinoma. Arch Pathol Lab Med. 1984 Mar;108(3):220–224. [PubMed] [Google Scholar]
  21. McDonald G. B., Brand D. L., Thorning D. R. Multiple adenomatous neoplasms arising in columnarlined (Barrett's) esophagus. Gastroenterology. 1977 Jun;72(6):1317–1321. [PubMed] [Google Scholar]
  22. Meyer W., Vollmar F., Bär W. Barrett-esophagus following total gastrectomy. A contribution to it's pathogenesis. Endoscopy. 1979 May;11(2):121–126. doi: 10.1055/s-0028-1098335. [DOI] [PubMed] [Google Scholar]
  23. Mossberg S. M. The columnar-lined esophagus (Barrett syndrome)--an acquired condition? Gastroenterology. 1966 May;50(5):671–676. [PubMed] [Google Scholar]
  24. Naef A. P., Savary M., Ozzello L. Columnar-lined lower esophagus: an acquired lesion with malignant predisposition. Report on 140 cases of Barrett's esophagus with 12 adenocarcinomas. J Thorac Cardiovasc Surg. 1975 Nov;70(5):826–835. [PubMed] [Google Scholar]
  25. Ozzello L., Savary M., Roethlisberger B. Columnar mucosa of the distal esophagus in patients with gastroesophageal reflux. Pathol Annu. 1977;12(Pt 1):41–86. [PubMed] [Google Scholar]
  26. Paull A., Trier J. S., Dalton M. D., Camp R. C., Loeb P., Goyal R. K. The histologic spectrum of Barrett's esophagus. N Engl J Med. 1976 Aug 26;295(9):476–480. doi: 10.1056/NEJM197608262950904. [DOI] [PubMed] [Google Scholar]
  27. Peuchmaur M., Potet F., Goldfain D. Mucin histochemistry of the columnar epithelium of the oesophagus (Barrett's oesophagus): a prospective biopsy study. J Clin Pathol. 1984 Jun;37(6):607–610. doi: 10.1136/jcp.37.6.607. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. SPICER S. S. DIAMINE METHODS FOR DIFFERENTIALING MUCOSUBSTANCES HISTOCHEMICALLY. J Histochem Cytochem. 1965 Mar;13:211–234. doi: 10.1177/13.3.211. [DOI] [PubMed] [Google Scholar]
  29. Schreiber D. S., Apstein M., Hermos J. A. Paneth cells in Barrett's esophagus. Gastroenterology. 1978 Jun;74(6):1302–1304. [PubMed] [Google Scholar]
  30. Segura D. I., Montero C. Histochemical characterization of different types of intestinal metaplasia in gastric mucosa. Cancer. 1983 Aug 1;52(3):498–503. doi: 10.1002/1097-0142(19830801)52:3<498::aid-cncr2820520320>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  31. Sipponen P., Seppälä K., Varis K., Hjelt L., Ihamäki T., Kekki M., Siurala M. Intestinal metaplasia with colonic-type sulphomucins in the gastric mucosa; its association with gastric carcinoma. Acta Pathol Microbiol Scand A. 1980 Jul;88(4):217–224. doi: 10.1111/j.1699-0463.1980.tb02489.x. [DOI] [PubMed] [Google Scholar]
  32. Skinner D. B., Walther B. C., Riddell R. H., Schmidt H., Iascone C., DeMeester T. R. Barrett's esophagus. Comparison of benign and malignant cases. Ann Surg. 1983 Oct;198(4):554–565. doi: 10.1097/00000658-198310000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Thompson J. J., Zinsser K. R., Enterline H. T. Barrett's metaplasia and adenocarcinoma of the esophagus and gastroesophageal junction. Hum Pathol. 1983 Jan;14(1):42–61. doi: 10.1016/s0046-8177(83)80045-8. [DOI] [PubMed] [Google Scholar]
  34. Trier J. S. Morphology of the epithelium of the distal esophagus in patients with midesophageal peptic strictures. Gastroenterology. 1970 Apr;58(4):444–461. [PubMed] [Google Scholar]

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