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Difference between revisions of "Esophagus"
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===Management=== | ===Management=== | ||
*Long term follow-up/repeat esophagogastroduodenoscopy. | *Long term follow-up/repeat esophagogastroduodenoscopy. | ||
==Gastroesophageal reflux disease== | ==Gastroesophageal reflux disease== | ||
| Line 212: | Line 186: | ||
*Iron (can be demonstrated with Prussian blue stain). | *Iron (can be demonstrated with Prussian blue stain). | ||
*Doxycycline. | *Doxycycline. | ||
==Dysplasia== | |||
===Classification=== | |||
*Indefinite for dysplasia. | |||
**Diagnose used in the context of uncertainty (like ''[[gynecologic cytopathology|ASCUS]]'' and ''[[prostate gland|ASAP]]''); usually used in the context of inflammation. | |||
*Low grade dysplasia. | |||
*High grade dysplasia. | |||
===Management=== | |||
Low grade dysplasia. | |||
*Follow-up. | |||
High grade dysplasia. | |||
*Endoscopic mucosal resection.<ref name=pmid19306943>{{cite journal |author=Sampliner RE |title=Endoscopic Therapy for Barrett's Esophagus |journal=Clin. Gastroenterol. Hepatol. |volume= |issue= |pages= |year=2009 |month=March |pmid=19306943 |doi=10.1016/j.cgh.2009.03.011 |url=}}</ref> | |||
*Surgical resection. | |||
===Microscopy=== | |||
Features: | |||
*Nuclear changes. | |||
**Nuclear hyperchromatism. | |||
**Nuclear crowding. | |||
**Cigar-shaped (ellipical) nuclei. | |||
*Nuclear changes present at surface (not only in gland crypts).<ref>GAG. January 2009.</ref> | |||
**If changes are present at the base but ''not'' at the luminal surface -- it "matures" and is ''not'' dysplasic. | |||
Notes: | |||
*Changes similar to those see in colorectal tubular adenomas. | |||
*Presence of goblet cells is mildly reassuring its not dysplasia.<ref>GAG. January 2009.</ref> | |||
==Cancer== | ==Cancer== | ||