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.
