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Reflux Esophagitis and Barrett Esophagus

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Surgical Pathology of Non-neoplastic Gastrointestinal Diseases

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Abstract

Gastroesophageal reflux disease may elicit a histologic reaction in the squamous mucosa of the esophagus. From a clinical perspective, it is divided into erosive and nonerosive forms. While no histologic feature is specific, reflux esophagitis is associated primarily with eosinophils. These are typically scattered within the epithelium and do not reach the intensity seen in eosinophilic esophagitis. Other features include basal cell hyperplasia, papillary elongation, spongiosis, and increased epithelial thickness. Prolonged reflux esophagitis may result in metaplastic transformation of the squamous mucosa to a columnar mucosa containing goblet cells, referred to as Barrett esophagus. This metaplastic mucosa is a preneoplastic condition, which may ultimately transform into adenocarcinoma through a dysplasia-carcinoma sequence. There are three morphologies of dysplastic Barrett mucosa: intestinal, foveolar, and serrated types. Grading dysplasia is a subjective endeavor and suffers from poor inter- and intra-observer agreement.

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    Jason T. Lewis

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Lewis, J.T. (2019). Reflux Esophagitis and Barrett Esophagus. In: Zhang, L., Chandan, V., Wu, TT. (eds) Surgical Pathology of Non-neoplastic Gastrointestinal Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-15573-5_3

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