Histopathology of Barrett's esophagus: A review for the practicing gastroenterologist

Barrett's esophagus (BE) is the replacement of the normal squamous lining of the distal esophagus by columnar mucosa. It is the recognized precursor of esophageal adenocarcinoma, with tumors arising through an inflammation–metaplasia–dysplasia–carcinoma sequence. Effective communication between the gastroenterologist and pathologist is crucial to the diagnosis, risk assessment, and management of BE. This review will focus on the histopathologic aspects of BE especially relevant to the practicing gastroenterologist, including discussion of normal anatomy and histology of the distal esophagus and gastroesophageal junction, varying definitions of BE used around the world, histology of nondysplastic BE, significance of goblet cells, grading of Barrett neoplasia, natural history of BE, biomarkers of progression, and pathology of postablation BE and endoscopic mucosal resection.

Keywords: Barrett's esophagus, Columnar-lined esophagus, Gastroesophageal junction, Intestinal metaplasia, Dysplasia, Adenocarcinoma