Difference between revisions of "Columnar dysplasia of the esophagus"

Jump to navigation Jump to search
+infobox
(split out)
(+infobox)
Line 1: Line 1:
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =
| Width      =
| Caption    =
| Synonyms  = columnar dysplasia, [[esophageal dysplasia]] (nonspecific)
| Micro      =
| Subtypes  = low-grade, high-grade
| LMDDx      = [[intestinal metaplasia of the esophagus]], [[esophageal adenocarcinoma]], [[basal crypt dysplasia]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[esophagus]] - distal
| Assdx      = [[Barrett's esophagus]], [[esophageal adenocarcinoma]], [[GERD]]
| Syndromes  =
| Clinicalhx = [[GERD]]
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = pre-malignant (benign)
| Other      =
| ClinDDx    =
| Tx        = low-grade: followup with biopsy; high-grade: resection (surgery, endoscopic mucosal resection)
}}
'''Columnar dysplasia of the esophagus''' is a pre-malignant lesion the [[esophagus]] associated with [[Barrett's esophagus]]. It is considered the precursor of [[esophageal adenocarcinoma]].
'''Columnar dysplasia of the esophagus''' is a pre-malignant lesion the [[esophagus]] associated with [[Barrett's esophagus]]. It is considered the precursor of [[esophageal adenocarcinoma]].


Line 5: Line 36:
and '''columnar epithelial dysplasia'''.<ref name=pmid3825997>{{Cite journal  | last1 = Hamilton | first1 = SR. | last2 = Smith | first2 = RR. | title = The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett's esophagus. | journal = Am J Clin Pathol | volume = 87 | issue = 3 | pages = 301-12 | month = Mar | year = 1987 | doi =  | PMID = 3825997 }}</ref>
and '''columnar epithelial dysplasia'''.<ref name=pmid3825997>{{Cite journal  | last1 = Hamilton | first1 = SR. | last2 = Smith | first2 = RR. | title = The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett's esophagus. | journal = Am J Clin Pathol | volume = 87 | issue = 3 | pages = 301-12 | month = Mar | year = 1987 | doi =  | PMID = 3825997 }}</ref>


===General===
==General==
*Arises in the setting of ''[[Barrett esophagus]]''.
*Arises in the setting of ''[[Barrett esophagus]]''.
*Precursor of [[esophageal adenocarcinoma]].


====Classification====
===Classification===
#Indefinite for dysplasia.
#Indefinite for dysplasia.
#*[[Diagnosis]] used in the context of uncertainty (like ''[[gynecologic cytopathology|ASCUS]]'' and ''[[prostate gland|ASAP]]''); the classic reason for its use is: the surface (epithelium) cannot be seen (which precludes assessment of maturation); may be used in the context of inflammation.
#*[[Diagnosis]] used in the context of uncertainty (like ''[[gynecologic cytopathology|ASCUS]]'' and ''[[prostate gland|ASAP]]''); the classic reason for its use is: the surface (epithelium) cannot be seen (which precludes assessment of maturation); may be used in the context of inflammation.
Line 14: Line 46:
#High grade dysplasia.
#High grade dysplasia.


====Management====
===Management===
Low grade dysplasia & indefinite for dysplasia:
Low grade dysplasia & indefinite for dysplasia:
*Follow-up.
*Follow-up.
Line 22: Line 54:
*Surgical resection (esophagectomy).
*Surgical resection (esophagectomy).


===Microscopic===
==Microscopic==
Features to assess:<ref name=Ref_GLP46>{{Ref GLP|46}}</ref>
Features to assess:<ref name=Ref_GLP46>{{Ref GLP|46}}</ref>
# Lack of surface maturation - very common, occasionally absent.<ref name=pmid16625087>{{Cite journal  | last1 = Lomo | first1 = LC. | last2 = Blount | first2 = PL. | last3 = Sanchez | first3 = CA. | last4 = Li | first4 = X. | last5 = Galipeau | first5 = PC. | last6 = Cowan | first6 = DS. | last7 = Ayub | first7 = K. | last8 = Rabinovitch | first8 = PS. | last9 = Reid | first9 = BJ. | title = Crypt dysplasia with surface maturation: a clinical, pathologic, and molecular study of a Barrett's esophagus cohort. | journal = Am J Surg Pathol | volume = 30 | issue = 4 | pages = 423-35 | month = Apr | year = 2006 | doi =  | PMID = 16625087 }}</ref>
# Lack of surface maturation - very common, occasionally absent.<ref name=pmid16625087>{{Cite journal  | last1 = Lomo | first1 = LC. | last2 = Blount | first2 = PL. | last3 = Sanchez | first3 = CA. | last4 = Li | first4 = X. | last5 = Galipeau | first5 = PC. | last6 = Cowan | first6 = DS. | last7 = Ayub | first7 = K. | last8 = Rabinovitch | first8 = PS. | last9 = Reid | first9 = BJ. | title = Crypt dysplasia with surface maturation: a clinical, pathologic, and molecular study of a Barrett's esophagus cohort. | journal = Am J Surg Pathol | volume = 30 | issue = 4 | pages = 423-35 | month = Apr | year = 2006 | doi =  | PMID = 16625087 }}</ref>
Line 59: Line 91:
*[[Esophageal adenocarcinoma]].
*[[Esophageal adenocarcinoma]].


====Images====
===Images===
No dysplasia - only intestinal metaplasia:
No dysplasia - only intestinal metaplasia:
*[http://www.nature.com/nrgastro/journal/v6/n8/fig_tab/nrgastro.2009.103_F4.html Intestinal metaplasia (nature.com)].
*[http://www.nature.com/nrgastro/journal/v6/n8/fig_tab/nrgastro.2009.103_F4.html Intestinal metaplasia (nature.com)].
Line 73: Line 105:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861756/figure/fig3/ High-grade columnar dysplasia (nih.gov)].<ref name=pmid17021130/>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861756/figure/fig3/ High-grade columnar dysplasia (nih.gov)].<ref name=pmid17021130/>


===Sign out===
==Sign out==
<pre>
<pre>
ESOPHAGUS, DISTAL, BIOPSY:
ESOPHAGUS, DISTAL, BIOPSY:
Line 91: Line 123:
- NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR MALIGNANCY.
</pre>
</pre>


==See also==
==See also==
48,830

edits

Navigation menu