Image Based Question – 73795

A 30-years-old male patient presents with a history of heartburn. An upper GI endoscopy was done and a biopsy from a suspicious lesion showed the following picture. What does this show? Which special  stains will you do for confirmation and what will you look for?

A. H. pylori infection, Silver stain, Gram-negative coccobaci Ili

B. Adenocarcinoma esophagus, mucin stain. mitotic figures

C. Squamous cell carcinoma, keratin stain

D. Barrett’s esophagus, mucin stain, dysplasia

Correct Answer » D Explanation

Ans: D. Barrett’s esophagus, mucin stain, dysplasia

(Ref Robbins 9/e p757, 758, 8/e p771)

• Image suggestive of Barrett’s esophagus.
• Extent of dysplasia is better delineated with mucin stain to rule out malignant trait.

Goblet cells:

• Metaplastic specialized (intestinalized columnar) epithelium in place of distal squamous mucosa.
• Also called “columnar lined esophagus”.
• Occur as response to chronic injury.
• Regresss after treatment.