Adequate histopathological assessment of biopsies and endoscopic resection specimens is of paramount importance in the management of Barrett’s oesophagus.
Surveillance and treatment decisions in patients with Barrett’s oesophagus are based on the presence and grade of dysplasia after histopathological assessment of surveillance biopsies and endoscopic resection (ER) specimens. Interobserver variation between pathologists is known to be high for diagnosing low-grade dysplasia. Differentiating between reactive changes resulting from inflammation and true low-grade dysplasia is often difficult. As a result of this, non expert pathologists frequently overdiagnose low-grade dysplasia. In “Histopathology of biopsies” the daily practice of evaluating surveillance biopsies and the overdiagnosis problem of low-grade dysplasia are discussed. A selection of histological slides is presented to aid in distinguishing low-grade dysplasia from reactive changes.
When assessing ER specimens it is paramount to adequately assess the presence of risk factors for lymph node metastasis. In “Histopathology of ER-specimens” the basic principles of preparing ER specimens for histological assessment, and the actual histological review of ER specimens are discussed.
A teaching module for Barrett’s histopathology is currently being developed for future use on this website. Initially the teaching module will consist of a set of histological slides from Barrett’s surveillance biopsies with a range of final diagnoses. Participants can go through the teaching module and will receive feedback on their diagnoses through annotations to the slides made by a panel of expert pathologists. Eventually, a second teaching module for the assessment of ER specimens will be included on the website.
