Pawan Khandre*, Vani B.R, Anvita N, Deepak Kumar B and Srinivasa Murthy V
INTRODUCTION
Barrett’s esophagus (BE) is a premalignant esophageal lesion found in 10% of patients with Gastroesophageal Reflux Disease (GERD) and 2% of the general population. The endoscopic appearance of salmon-colored mucosa measuring ≥1 cm proximal to the gastroesophageal junction, combined with intestinal metaplasia (IM) on biopsy, is diagnostic. IM that contains goblet cells has a higher risk for esophageal cancer. The most common histopathological finding is the replacement of squamous epithelium by gastric or intestinal-type metaplastic columnar epithelium. This study aims to evaluate the various histomorphological features of BE and their association with clinical features and endoscopic findings.
MATERIALS AND METHODOLOGY
This study is a cross-sectional analysis conducted in the histopathology section of the Department of Pathology over a three-month period. All diagnosed cases of BE were included in the research. Clinical details were gathered from departmental case files and medical record archives. H and E and PAS-stained slides were retrieved and examined for morphology, while Giemsa-stained slides were analyzed for the presence of Helicobacter pylori.
RESULTS
Of the total 84 endoscopic esophageal biopsies collected during the study period, 20 revealed microscopic Barrett's Esophagus (BE). Patient ages ranged from 24 to 86 years, with a mean age at BE presentation of 58.8 years and a male-to-female ratio of 5.7:1. In this study, the most common clinical presentation was heartburn, which accounted for 65% of cases. Hyperemia was the predominant feature observed during endoscopy in 11 (55%) cases. The BE cases were classified into three categories: no dysplasia, low-grade dysplasia and high-grade dysplasia, which corresponded to 13 (65%) cases, 6 (30%) cases and 1 (5%) case, respectively. Esophagitis was noted in 9 cases of BE, comprising 83.5% (5 cases) of low-grade dysplasia and 100% (1 case) of high-grade dysplasia cases.
CONCLUSION
BE follows an indolent course and stands as a significant precursor to malignancy. Thus, endoscopic examination and histopathological analysis of the altered esophageal mucosa are essential for a definitive diagnosis and ongoing follow-up.
