Histopathology of Early Neoplasia in Barrett’s Esophagus

  • Jeremy R. Jass


The evolution of early epithelial neoplasia in the lower esophagus occurs in three principal stages. Inflammation and ulceration due to chemical irritation caused by gastroesophageal reflux results in replacement of the squamous epithelium of the lower esophagus by a columnar epithelium showing intestinal differentiation. The columnar epithelial lining, or Barrett’s esophagus, is classified as the long type when the segment is ≥3 cm or the short type when the length is <3 cm. The second stage is the development of focal or multifocal intraepithelial neoplasia (dysplasia) within Barrett’s esophagus. The final stage is the emergence of an invasive (malignant) subclone spreading sequentially into lamina propria, muscularis mucosae, and submucosa. From the diagnostic perspective, critical issues are the diagnosis of Barrett’s esophagus, the distinction between reactive change and unequivocal intraepithelial neoplasia, and the recognition of high-grade intraepithelial neoplasia requiring surgical intervention.


Goblet Cell Intestinal Metaplasia Endoscopic Mucosal Resection Intraepithelial Neoplasia Neoplastic Change 


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Copyright information

© Springer Japan 2002

Authors and Affiliations

  • Jeremy R. Jass
    • 1
  1. 1.Department of PathologyUniversity of Queensland School of MedicineHerstonAustralia

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