title: A clinical and histopathologic focus on Barrett esophagus and Barrett-related dysplasia.
abstract: BACKGROUND
  Barrett esophagus is a metaplastic, premalignant lesion associated with approximately 0.5% annual incidence of progression to esophageal adenocarcinoma. Diagnosis and screening of Barrett esophagus and Barrett-related dysplasia relies on histologic evaluation of endoscopic mucosal biopsies, a process that is burdened with interobserver variability.
  
  
  OBJECTIVE
  To review the histologic features and classification of Barrett esophagus and Barrett-related dysplasia, to discuss the underlying difficulties in diagnosis and pitfalls, and to provide a brief review of new developments related to therapeutic modalities for patients diagnosed with dysplasia.
  
  
  METHODS
  Sources include a review of relevant literature indexed in PubMed (US National Library of Medicine).
  
  
  CONCLUSIONS
  In spite of interobserver variability, histologic assessment of dysplasia is currently the accepted method of surveillance, and subsequent patient management is dictated by this evaluation. Although not universal, endoscopic therapy is increasingly important in replacing esophagectomy for patients with high-grade dysplasia or early carcinoma.
authors.affiliation: Department of Pathology, George Washington University Hospital, Washington, DC, USA.
authors.forename: Lysandra
authors.initials: L
authors.lastname: Voltaggio
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Montgomery
authors.forename: Dora
authors.initials: D
authors.lastname: Lam-Himlin
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D001471:Barrett Esophagus / Q000175:diagnosis / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology; D004945:Esophagoscopy; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D007150:Immunohistochemistry; D008679:Metaplasia; D011230:Precancerous Conditions / Q000473:pathology; D012307:Risk Factors