48,830
edits
Difference between revisions of "Columnar dysplasia of the esophagus"
Jump to navigation
Jump to search
Columnar dysplasia of the esophagus (view source)
Revision as of 00:53, 3 April 2014
, 00:53, 3 April 2014+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== | |||
*Arises in the setting of ''[[Barrett esophagus]]''. | *Arises in the setting of ''[[Barrett esophagus]]''. | ||
*Precursor of [[esophageal adenocarcinoma]]. | |||
===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=== | |||
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== | |||
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=== | |||
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== | |||
<pre> | <pre> | ||
ESOPHAGUS, DISTAL, BIOPSY: | ESOPHAGUS, DISTAL, BIOPSY: | ||
| Line 91: | Line 123: | ||
- NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR MALIGNANCY. | ||
</pre> | </pre> | ||
==See also== | ==See also== | ||