[50 years of Barrett esophagus. Current diagnostic possibilities in pathology].
The most important differential diagnosis of specialized intestinal columnar cell metaplasia (Barrett's-mucosa) is the intestinal metaplasia of the cardia mucosa (possibly caused by Helicobacter infection). Furthermore it happens from time to time that Barrett's regenerative epithelium is overdiagnosed as low-grade dysplasia (unequivocal intraepithelial neoplasia). This might explain the disappearance of many low-grade dysplasias during further follow-up. Mucosal adenocarcinomas are often underdiagnosed as dysplastic lesions. Therefore many authors tried to establish molecular methods for improvement of the diagnostic possibilities. Immunohistochemistry or PCR with p53 and HER 2-neu might give at least some help but a negative reaction does not exclude a neoplasia in every case. The gold standard is careful endoscopy and biopsy taking with good documentation of the endoscopical findings and most important still the routine H&E stain are the only reliable diagnostic tools.
Institut für Pathologie, Klinikum Bayreuth, 95445 Bayreuth. vieth.lkpathol@uni-bayreuth.de
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D000230:Adenocarcinoma / Q000473:pathology*; D001471:Barrett Esophagus / Q000235:genetics / Q000473:pathology*; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000473:pathology*; D004947:Esophagus / Q000473:pathology; D006801:Humans; D009092:Mucous Membrane / Q000473:pathology; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53