Difference between revisions of "Basal crypt dysplasia"
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'''Basal crypt dysplasia''', abbreviated '''BCD | '''Basal crypt dysplasia''', abbreviated '''BCD''', is a dysplastic change reported in the [[esophagus]] that involves the crypt bases but ''not'' the surface.<ref name=pmid23695891>{{Cite journal | last1 = Khan | first1 = S. | last2 = McDonald | first2 = SA. | last3 = Wright | first3 = NA. | last4 = Graham | first4 = TA. | last5 = Odze | first5 = RD. | last6 = Rodriguez-Justo | first6 = M. | last7 = Zeki | first7 = S. | title = Crypt dysplasia in Barrett's oesophagus shows clonal identity between crypt and surface cells. | journal = J Pathol | volume = 231 | issue = 1 | pages = 98-104 | month = Sep | year = 2013 | doi = 10.1002/path.4211 | PMID = 23695891 }}</ref> | ||
It may be referred to as '''crypt dysplasia-like atypia'''<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> and '''crypt dysplasia'''. | It may be referred to as '''crypt dysplasia-like atypia'''<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> and '''crypt dysplasia''' (abbreviated '''CD'''). | ||
The conventional thinking has been that dysplasia ''always'' involve the surface epithelium; BCD violates the saying ''normal is '''d'''ark '''d'''eep and '''l'''ight '''l'''uminal.'' This entity is consider to be an emerging concept;<ref name=pmid21970480>{{Cite journal | last1 = Voltaggio | first1 = L. | last2 = Montgomery | first2 = EA. | last3 = Lam-Himlin | first3 = D. | title = A clinical and histopathologic focus on Barrett esophagus and Barrett-related dysplasia. | journal = Arch Pathol Lab Med | volume = 135 | issue = 10 | pages = 1249-60 | month = Oct | year = 2011 | doi = 10.5858/arpa.2011-0019-RA | PMID = 21970480 }}</ref> it is not completely without controversy. | |||
==General== | ==General== | ||
*Molecular changes in the crypt base can be identified in the surface cells.<ref name=pmid23695891/> | *Molecular changes in the crypt base can be identified in the surface cells.<ref name=pmid23695891/> | ||
*Strong association with conventional dysplasia/adenocarcinoma. | *Strong association with conventional dysplasia/adenocarcinoma. | ||
**In one series, 87% of individual with BCD had dysplasia ''or'' adenocarcinoma in other tissue samples.<ref name=pmid16625087/> | **In one series, 87% of individual with BCD had [[columnar dysplasia of the esophagus|columnar dysplasia]] ''or'' [[esophageal adenocarcinoma|adenocarcinoma]] in other tissue samples.<ref name=pmid16625087/> | ||
*Reproducibility among pathologists is worse than [[columnar dysplasia of the esophagus|high-grade dysplasia]] but better than low-grade dysplasia.<ref name=pmid21970480/> | |||
==Microscopic== | ==Microscopic== | ||
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**Nuclear crowding (pseudostratification). | **Nuclear crowding (pseudostratification). | ||
*Non-dysplastic (normal) surface epithelium.<ref name=pmid23695891/> | *Non-dysplastic (normal) surface epithelium.<ref name=pmid23695891/> | ||
DDx: | |||
*Indefinite for [[columnar dysplasia of the esophagus]]. | |||
*[[Columnar dysplasia of the esophagus]]. | |||
==Sign out== | |||
*Cut levels to look for a definite lesion. | |||
*Probably best to avoid; call it "indefinite for dysplasia". | |||
Note: | |||
*Voltaggio ''et al.'' advocate it should be treated like low-grade dysplasia (requires a follow-up biopsy).<ref name=pmid21970480/> | |||
==See also== | ==See also== | ||
Latest revision as of 15:33, 10 July 2016
Basal crypt dysplasia, abbreviated BCD, is a dysplastic change reported in the esophagus that involves the crypt bases but not the surface.[1]
It may be referred to as crypt dysplasia-like atypia[2] and crypt dysplasia (abbreviated CD).
The conventional thinking has been that dysplasia always involve the surface epithelium; BCD violates the saying normal is dark deep and light luminal. This entity is consider to be an emerging concept;[3] it is not completely without controversy.
General
- Molecular changes in the crypt base can be identified in the surface cells.[1]
- Strong association with conventional dysplasia/adenocarcinoma.
- In one series, 87% of individual with BCD had columnar dysplasia or adenocarcinoma in other tissue samples.[2]
- Reproducibility among pathologists is worse than high-grade dysplasia but better than low-grade dysplasia.[3]
Microscopic
Features:
- Definite "dysplastic changes" in the crypt base:
- Hyperchromasia - important.
- Nuclear enlargement.
- Nuclear crowding (pseudostratification).
- Non-dysplastic (normal) surface epithelium.[1]
DDx:
- Indefinite for columnar dysplasia of the esophagus.
- Columnar dysplasia of the esophagus.
Sign out
- Cut levels to look for a definite lesion.
- Probably best to avoid; call it "indefinite for dysplasia".
Note:
- Voltaggio et al. advocate it should be treated like low-grade dysplasia (requires a follow-up biopsy).[3]
See also
References
- ↑ 1.0 1.1 1.2 Khan, S.; McDonald, SA.; Wright, NA.; Graham, TA.; Odze, RD.; Rodriguez-Justo, M.; Zeki, S. (Sep 2013). "Crypt dysplasia in Barrett's oesophagus shows clonal identity between crypt and surface cells.". J Pathol 231 (1): 98-104. doi:10.1002/path.4211. PMID 23695891.
- ↑ 2.0 2.1 Lomo, LC.; Blount, PL.; Sanchez, CA.; Li, X.; Galipeau, PC.; Cowan, DS.; Ayub, K.; Rabinovitch, PS. et al. (Apr 2006). "Crypt dysplasia with surface maturation: a clinical, pathologic, and molecular study of a Barrett's esophagus cohort.". Am J Surg Pathol 30 (4): 423-35. PMID 16625087.
- ↑ 3.0 3.1 3.2 Voltaggio, L.; Montgomery, EA.; Lam-Himlin, D. (Oct 2011). "A clinical and histopathologic focus on Barrett esophagus and Barrett-related dysplasia.". Arch Pathol Lab Med 135 (10): 1249-60. doi:10.5858/arpa.2011-0019-RA. PMID 21970480.