This review focuses on conceptual aspects of Barrett's esophagus and Barrett's related dysplasia and highlights current diagnostic problems on the interpretation of these lesions. Barrett's esophagus results from longstanding gastroesophageal reflux. Endoscopically it is recognized by the presence of glandular mucosa in the tubular esophagus above the esophagogastric junction at variable lenghts. Histologically it is characterized by the presence of specialized columnar epithelium with globet cells expressed as intestinal metaplasia. The importance of Barret's esophagus is the risk for developing adenocarcinoma. Dysplasia is the main biomarker for the progression to adenocarcinoma. The pathologic diagnosis of Barrett's esophagus should contain information on the presence and grade of dysplasia. Distinguishing betweeen dysplasia and regenerative changes in the face of active inflammation may be difficult. Correct interpretation and grading of dysplasia is an important goal for pathologists, since it is a major factor on follow-up and treatment of the patients.
Barrett's esophagus; Dysplasia; Diagnosis
