To define the histology of the columnarlined esophagus, we obtained esophageal biopsies from various levels with manometric control from 11 patients. There were three types of columnar epithelia above the lower esophageal sphincter: atrophic gastric-fundic-type epithelium with parietal and chief cells; junctional-type epithelium with cardiac mucous glands; and distinctive specialized columnar epithelium with a villiform surface, mucous glands and intestinal-type goblet cells. When present, specialized columnar epithelium was always the most proximal, and gastric fundic epithelium the most distal epithelium. Junctional epithelium was interposed between gastric fundic and specialized columnar or squamous epithelium. Four patients had unequivocal esophagitis in squamous epithelium, but its presence and severity did not correlate with inflammation in or length or type of distal columnar epithelium. Histoligic study of the columnar-lined esophagus demonstrated a spectrum of epithelial patterns. This heterogeneity helps to explain prior discrepant reports.
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Rugge, M, Russo, V, Busatto, G, Genta, R M, Di Mario, F, Farinati, F, Graham, D Y
(2001). The phenotype of gastric mucosa coexisting with Barrett's oesophagus. J. Clin. Pathol.
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[Abstract][Full Text]
Arul, G S, Moorghen, M, Myerscough, N, Alderson, D A, Spicer, R D, Corfield, A P
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[Abstract][Full Text]
Ibrahim, N. B N
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53: 89-94
[Full Text]
Peters, F T M, Ganesh, S, Kuipers, E J, Sluiter, W J, Klinkenberg-Knol, E C, Lamers, C B H W, Kleibeuker, J H
(1999). Endoscopic regression of Barrett's oesophagus during omeprazole treatment; a randomised double blind study. Gut
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[Abstract][Full Text]
Morales, T. G., Sampliner, R. E.
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159: 1411-1416
[Abstract][Full Text]
Mattioli, S., D'Ovidio, F., Di Simone, M. P., Bassi, F., Brusori, S., Pilotti, V., Felice, V., Ferruzzi, L., Guernelli, N.
(1998). Clinical and surgical relevance of the progressive phases of intrathoracic migration of the gastroesophageal junction in gastroesophageal reflux disease. J. Thorac. Cardiovasc. Surg.
116: 267-275
[Abstract][Full Text]
van Sandick, J W, van Lanschot, J J B, Kuiken, B W, Tytgat, G N J, Offerhaus, G J A, Obertop, H
(1998). Impact of endoscopic biopsy surveillance of Barrett's oesophagus on pathological stage and clinical outcome of Barrett's carcinoma. Gut
43: 216-222
[Abstract][Full Text]
Hackelsberger, A, Gunther, T, Schultze, V, Manes, G, Dominguez-Munoz, J-E, Roessner, A, Malfertheiner, P
(1998). Intestinal metaplasia at the gastro-oesophageal junction: Helicobacter pylori gastritis or gastro-oesophageal reflux disease?. Gut
43: 17-21
[Abstract][Full Text]
FITZGERALD, R C, BURNHAM, W R, MACDONALD, C E, WICKS, A C, PLAYFORD, R J
(1998). Consideration of histopathological subtypes and biopsy techniques in Barrett's oesophagus surveillance programmes • Reply. Gut
42: 448a-448
[Full Text]
Trudgill, N J, Suvarna, S K, Kapur, K C, Riley, S A
(1997). Intestinal metaplasia at the squamocolumnar junction in patients attending for diagnostic gastroscopy. Gut
41: 585-589
[Abstract][Full Text]
Rice, T. W., Goldblum, J. R., Falk, G. W., Tubbs, R. R., Kirby, T. J., Casey, G.
(1994). p53 Immunoreactivity in Barrett's metaplasia, dysplasia, and carcinoma. J. Thorac. Cardiovasc. Surg.
108: 1132-1137
[Abstract][Full Text]
Sampliner, R. E.
(1986). Does Barrett's Esophagus Need to Be Detected?. Arch Intern Med
146: 43-44
[Abstract]
BOZYMSKI, E. M., HERLIHY, K. J., ORLANDO, R. C.
(1982). Barrett's Esophagus. ANN INTERN MED
97: 103-107
[Abstract]
Kothari, T., Mangla, J. C., Kalra, T. M. S.
(1980). Barrett's Ulcer and Treatment With Cimetidine. Arch Intern Med
140: 475-477
[Abstract]
Shapira, M., Bassan, H. M., Rizescu, J.
(1979). Benign Esophageal Polyp With Barrett's Syndrome. JAMA
242: 2589-2589
[Abstract]
GASTROENTEROLOGY COMMITTEE,
(1979). Gastroenterology: An Annotated Bibliography of Recent Literature: References to Journal Articles and Other Papers. ANN INTERN MED
91: 799-803
[Abstract]
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