Epithelial Tumors of the Gastrointestinal Tract: Definitional Problems Regarding Morphologic Terminology

  • Klaus J. Lewin
Conference paper


These are Major terminological problems relating to definitions of epithelial tumors of the whole gastrointestinal tract (squamous and glandular). Furthermore, the clinical implications vary from site to site. The definitional problems primarily involve epithelial atypia and the terminology of neoplastic lesions, namely dysplasia, adenomas, carcinoma in situ, and early cancer [1–8].


Ulcerative Colitis Severe Dysplasia Cytological Atypia Dysplastic Lesion Malignant Epithelial Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dawsey SM, Lewin KJ (1995) Histologic precursors of squamous esophageal cancer. Pathol Annu 30:209–226PubMedGoogle Scholar
  2. 2.
    Goldstein NS, Lewin KJ (1997) Gastric epithelial dysplasia and adenoma: historical review and histological criteria for grading. Hum Pathol 28:127–133PubMedCrossRefGoogle Scholar
  3. 3.
    Jass JR (1983) A classification of gastric dysplasia. Histopathology 7:181–193PubMedCrossRefGoogle Scholar
  4. 4.
    Lewin KJ, Appelman HD (1996) AFIP fascicle on tumors of the esophagus and stomach. Carcinoma of the stomach. pp 245–321Google Scholar
  5. 5.
    Lewin KJ (1998) Nomenclature problems of gastrointestinal epithelial neoplasia. Am J Surg Pathol 22:1043–1047PubMedCrossRefGoogle Scholar
  6. 6.
    Morson BC, Dawson IMP, Day DW, et al. (1990) Malignant epithelial tumors of stomach. In: Gastrointestinal pathology. Blackwell Scientific, Oxford, London, pp 143–169Google Scholar
  7. 7.
    Morson BC, Dawson IMP, Day DW, et al. (1990) Colon: benign epithelial tumors and polyps. In: Gastrointestinal pathology. Blackwell Scientific, Oxford, London, pp 143–169Google Scholar
  8. 8.
    Schlemper RJ, Itabashi M, Kato Y, et al. Differences in diagnostic criteria for gastric carcinoma between Japanese and Western pathologists. Lancet 349:1725–1729Google Scholar
  9. 9.
    Barwick KW (1982) Gastric epithelial dysplasia: how reliably can it be recognized and what does it mean? J Clin Gastroenterol 4:493–496PubMedCrossRefGoogle Scholar
  10. 10.
    Cuello C, Correa P, Zarama G, et al. (1979) Histopathology of gastric dysplasia. Am J Surg Pathol 3:491–500PubMedCrossRefGoogle Scholar
  11. 11.
    Farini R, Arslan-Pagnini C, Farinati F (1983) Is mild epithelial dysplasia an indication for follow-up? J Clin Gastroenterol 5:307–310PubMedCrossRefGoogle Scholar
  12. 12.
    Haggitt RC (1994) Barrett’s esophagus, dysplasia and adenocarcinoma. Hum Pathol 25:982–993PubMedCrossRefGoogle Scholar
  13. 13.
    Nagayo T (1971) Histological diagnosis of biopsied gastric mucosa with special reference to that of borderline lesions. Gann Monogr Cancer Res 11:245–256Google Scholar
  14. 14.
    Ochlert W, Keller P, Henke M, et al. (1979) Gastric mucosal dysplasia: what is its clinical significancc? Front Gastrointest Res 4:173–182Google Scholar
  15. 15.
    Riddell RH, Goldman H, Ransohoff DF, et al. (1983) Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications. Hum Pathol 14:931–968PubMedCrossRefGoogle Scholar
  16. 16.
    Saito K, Shimoda T (1986) The histogenesis and early invasion of gastric cancer. Acta Pathol Jpn 36:1307–1318PubMedGoogle Scholar
  17. 17.
    Schade ROK (1974) The borderline between benign and malignant lesions of the stomach. In: Grundmann E, Grunze H, Witte S (eds) Early gastric cancer. Berlin Heidelberg Springer, New York, pp 45–53CrossRefGoogle Scholar
  18. 18.
    Ming SC (1992) Adenocarcinoma and other malignant epithelial tumors of the stomach. In: Goldman H, Ming SC (eds) Pathology of the gastrointestinal tract. Saunders, Philadelphia, pp 584–617Google Scholar
  19. 18.
    Sugano H, Nakamura K, Takagi K (1971) An atypical epithelium of the stomach. Gann Monogr Cancer Res 11:257–269Google Scholar
  20. 19.
    Fertitta AM, Comin U, Tcrruzzi V, et al. (1993) Clinical significance of gastric dysplasia: a multicentric follow-up study. Endoscopy 25:265–268PubMedCrossRefGoogle Scholar
  21. 20.
    Grundman E (1975) Histologic types and possible initial stages in early gastric carcinoma. Beit-Pathol 154:256–280CrossRefGoogle Scholar
  22. 21.
    Lansdown M, Quirke P, Dixon MF, et al. (1990) High grade dysplasia of the gastric mucosa: A marker for gastric carcinoma. Gut 31:977–983PubMedCrossRefGoogle Scholar
  23. 22.
    de Dombal FT, Price AB, Thompson H, et al. (1990) The British Society of Gastroenterology early gastric cancer/dysplasia survey: an intcrim report. Gut 31:115–120PubMedCrossRefGoogle Scholar
  24. 22.
    Nagayo T (1986) Gastric cancer preceded by severe dysplasia. Histol Histopathol 1:171–180PubMedGoogle Scholar
  25. 23.
    Reid BJ, Haggitt RC, Rubin CE, et al. (1988) Observer variation in the diagnosis of dysplasia in Barrett’s esophagus. Hum Pathol 19:166–178PubMedCrossRefGoogle Scholar
  26. 24.
    Bernstein CN, Weinstein WM, Levine DS, et al. (1995) Physicians’ perceptions of dysplasia and approaches to surveillance colonoscopy in ulcerative colitis. Am J Gastroenterol 90:2106–2114PubMedGoogle Scholar
  27. 25.
    Blackstone MO, Riddell RH, Gerald Rogers BH, et al. (1981) Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy. Gastroenterology 80:366–374PubMedGoogle Scholar
  28. 26.
    Garewall HS, Sampliner R, Fennerty MB (1991) Flow cytometry in Barrett’s esophagus. What have we learnt so far? Dig Dis Sci 36:548–551CrossRefGoogle Scholar
  29. 27.
    Löfberg R, Broström O, Karlén P, et al. (1992) DNA aneuploidy in ulcerative colitis: reproducibility, topographic distribution, and relation to dysplasia. Gastroenterology 102:1149–1154PubMedGoogle Scholar
  30. 28.
    Reid BJ, Blount PL, Rubin CE, et al. (1992) Predictors of progression to malignancy in Barrett’s esophagus: endoscopic, histologic and flow cytometric follow-up of a cohort. Gastroenterology 102:1212–1219PubMedGoogle Scholar
  31. 31.
    Tosi P, Baak JPA, Luzi P, et al. (1989) Morphometric distinction of low-and high-grade dysplasias in gastric biopsies. Hum Pathol 20:839–844PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1999

Authors and Affiliations

  • Klaus J. Lewin
    • 1
  1. 1.UCLA School of MedicineLos AngelesUSA

Personalised recommendations