A. Endoscopic Biopsy
B. Screening Endoscopy
D. CT scan
Ans:A. Endoscopic Biopsy.
The patient is suffering from Barrett’s Esophagus.
Image shows:Barrett’s oesophagus. Part of the oesophagus which is normally lined by squamous epithelium undergoes metaplastic change to columnar epithelium of intestinal type.
- This is a condition in which, following reflux oesophagitis, stratified squamous epithelium of the lower oesophagus is replaced by columnar epithelium (columnar metaplasia).
- Barrett’s oesophagus is a premalignant condition evolving sequentially from Barrett’s epithelium (columnar metaplasia) → dysplasia → carcinoma in situ →oesophageal adenocarcinoma.
- Endoscopically, the affected area is red and velvety.
- Hiatus hernia and peptic ulcer at squamocolumnar junction (Barrett’s ulcer) are frequently associated.
- Microscopically, the most common finding is the replacement of squamous epithelium by metaplastic columnar cells.
- Barrett’s oesophagus may be composed of intestinal epithelium, fundic gastric glands, or cardiac mucous glands.
- Other cells present in the glands may be Paneth cells , goblet cells, chief cells, parietal cells, mucus-secreting cells and endocrine cells.
- Endoscopic biopsy is the gold standard for confirmation of Barrett’s esophagus.