Contributed by Anthony J. Demetris, M.D.
PATIENT HISTORY:
Per referral report, the patient is a 31-year-old male with questionable Barrett's, low grade dysplasia. Review of outside material.

Final Diagnosis (Case 3)


ENDOSCOPIC BIOPSIES OF ESOPHAGUS AT 40 CM. (Part A), 38 CM. (Part B), 36 CM.(36 cm.), AND 34 CM. (Part D) -
  1. SQUAMOUS AND GASTRIC MUCOSA WITH MILD CHRONIC PLASMACYTIC INFLAMMATION.
  2. GASTRIC AND GOBLET CELL METAPLASIA PRESENT IN PARTS C AND D, INDICATIVE OF BARRETT'S CHANGE 1. REGENERATIVE EPITHELIUM WITH ATYPIA, SUGGESTIVE OF LOW GRADE DYSPLASIA (see microscopic description).

Previous Biopsies on this Patient:
None

TPIS Related Resources:
None.

Gross Description (Case 3)


The specimen consists of eight (8) consult slides with an accompanying surgical pathology report.

Microscopic Description (Case 3)


(8 HE)
Part A(40 cm) and Part B(38 cm), shows gastric and acanthotic squamous mucosa with glycogen vacuolization. Some of gastric-type mucosa shows mild to moderate chronic, lymphoplasmacytic inflammation and mild regenerative change. A tiny focus of metaplastic surface glands is also seen.

Part C, from 36 cm., and Part D, from 34 cm., are similar in appearance. They consist of fragments of glandular, gastric-type mucosa showing focal goblet cell metaplasia, stratification of the glandular epithelium in some areas, and an increased nuclear:cytoplasmic ratio. There is also a slight increased complexity of some of the involved glands. In most, but not all areas, these atypical changes do not extend to the surface epithelium, a pattern suggestive of early, mild dysplastic change arising in a regenerative background.

Please mail comments, corrections or suggestions to the TPIS administration at the UPMC.