Risk factors: hiatal hernia, duodenogastricreflux ,delayed acid clearance time,
↓LESp Adult disorder → 376 per 100000 Irreversible conditionM/F = 2/1
Specialized columnar epithelium with goblet
cells (positive for Alcian blue in pH:2.5)
Absence of goblet cells is insufficient to make
a definitive diagnosis
“Barrett cytokeratin 7/20 pattern ”
Negative for dysplasia
Indefinite for dysplasia
Low grade dysplasia
High grade dysplasia
Surface maturation (low power)
Architecture (low power)
Cytologic features
Inflammation and erosions/ulcers
Surface epithelium more mature than
underlying glands Normal architecture Nuclear stratification - ↑N/C, small nucleoli,
mitoses are normal in Deeper glands Nuclear polarity and, smooth outlines are
preserved in Deep and superficial
Nuclear membrane irregularity,
hyperchromasia in Deep ,with normal maturation to surface
Active PMN infiltration
No polarity disturbance No architectural abnormality
Extension of cytological abnormalities to
surface (at least focally)
No maturation to surface
Abundant inflammation, prominent nucleoli,
abnormal architectures and loss of polarity
are not LGD features .
Prominent cytologic abnormalities
Markedly distorted glands
Little intervening lamina propria
DNA content (flowcytometry)
P53 → progression