RéSUMé
Diverses modifications épithéliales s’observent sur l’épithélium de Barrett, qui est lui-même une métaplasie post-inflammatoire. Les modifications les plus importantes sont les remaniements néoplasiques, en raison de leurs implications importantes du point de vue diagnostique, surveillance et pronostic. Le diagnostic d’une dysplasie de faible degré est souvent difficile, en raison du manque de clarté de la distinction histologique entre dysplasic véritable et épithélium régénératif pseudodysplasique. Dès lors, le concept d’épithélium « en dysplasie indéterminée » a nettement évolué. Chaque biopsie prélevée sur une muqueuse d’épithélium de Barrett a des implications sur la conduite de la surveillance, qui va du simple suivi de l’épithélium néoplasique à la surveillance stricte qui concerne les états allant de l’épithélium indéterminé à la résection pour carcinome.
Summary
A variety of epithelial changes occur in Barren’s mucosa, which itself is a posl- inflammatory metaplasia. The most important of these are the neoplastic alterations, including the dysplasias and carcinomas, because they have significant implications in terms of management and prognosis. The diagnosis of low grade dysplasia is often difficult, because the histologie distinction between true dysplasia and dysplasia- like regenerative epithelium is not always clear. Thus the concept of epithelium « indefinite for dysplasia » has evolved. Every biopsy of a Barrett’s mucosa carries with it implications for patient management which vary from simple follow- up for non-neoplastic epithelium to rigorous surveillance for indefinite epithelium to resection for carcinoma.
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Appelman, H.D. Les altérations histologiques observées au cours de la surveillance de l’endobrachyœsophage. Acta Endosc 22, 517–530 (1992). https://doi.org/10.1007/BF02965115
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DOI: https://doi.org/10.1007/BF02965115