Barrett's Oesophagus
 Barrett's Support Forum :Barrett's Support Forum :Barrett's Oesophagus  
Message Icon Topic: New Member Post Reply Post New Topic
Author Message
Ad1011
Newbie Plus
Newbie Plus


Joined: 14 Feb 2018
Location: United States
Online Status: Offline
Posts: 1
Quote Ad1011 Replybullet Topic: New Member
    Posted: 21 Feb 2018 at 11:22pm
Hi All,

Recently was diagnosed with Barrett's. Came as quite the shock. Im 31, eat pretty well, not overweight and never get reflux, not in the past, not presently. I live in the US and the GI doc said he saw a bit of barretts after my endoscopy but the rest is a blur as i was just waking up. Got the biopsy results back a few days later and am a little confused about what they mean. Wont have my follow up apt for a few more weeks and trying to put my worries at ease. Thought you all may be able to help a bit!

Here is snipits from my path report:

This is what he mentioned when sent to pathology:

Preoperative Diagnosis: Normal mucosa in the whole examined duodenum, antrum and whole stomach. Irregularity in the Z-line and gastroesophageal junction.
Postoperative Diagnosis: Localized irregularity of the mucosa was noted in the Z-line and gastroesophageal junction with less than 0.1 cm proximal extension. These findings raise suspicion for Barrett's intestinal metaplasia. Multiple cold forceps biopsies were performed for histology. Normal mucosa was noted in the antrum and whole stomach. Multiple cold forceps biopsies were performed for H. pylori in the stomach antrum. Normal mucosa was noted in the whole examined duodenum. Multiple cold forceps biopsies were performed for celiac disease in the whole examined duodenum.

After biopsy:

Final Diagnosis:

1.   DUODENUM, BIOPSY:
       A.   FRAGMENTS OF DUODENAL MUCOSA WITH PRESERVED VILLOUS ARCHITECTURE AND NO INCREASE IN INTRAEPITHELIAL LYMPHOCYTES/CELIAC SPRUE

2.    ANTRUM, BIOPSY:
       A.   MINIMAL CHRONIC GASTRITIS
       B.   NO INTESTINAL METAPLASIA OR DYSPLASIA IDENTIFIED
       C.   NO MORPHOLOGIC EVIDENCE OF HELICOBACTER PYLORI

3.    GASTROESOPHAGEAL JUNCTION, BIOPSY:
       A.   GASTRIC TYPE MUCOSA WITH CHRONIC INFLAMMATION AND FOCAL INTESTINAL METAPLASIA CONSISTENT WITH BARRETT'S ESOPHAGUS
       B.   NO DYSPLASIA IDENTIFIED
       C.   ESOPHAGEAL SQUAMOUS TYPE EPITHELIUM WITH MILD REACTIVE CHANGES


Sample sizes:

The specimen is received in three parts.

Part 1 is received in buffered formalin labeled with the patient identifiers (AD) and designated as "duodenum".
Number of tissue fragments: 6
Size: 0.2 to 0.4 cm
Entirely submitted in cassette labeled: 1A

Part 2 is received in buffered formalin labeled with the patient identifiers (AD) and designated as "antrum".
Number of tissue fragments: 2
Size: 0.2 and 0.4 cm
Entirely submitted in cassette labeled: 2A

Part 3 is received in buffered formalin labeled with the patient identifiers (AD) and designated as "GE junction".
Number of tissue fragments: 1
Size: 0.5
Entirely submitted in cassette labeled: 3A (WB/rdh)



My questions are:
1. Does this suggest i have 1mm of barrets?
2. Everything ive read states they take at least 4 biopsies from the suspected tissue, im only seeing 1, any ideas?

Any help or your thoughts would be appreciated. And thank you all for contributing to this forum, its the only place ive found decent information on this topic. Been lurking for awhile until i got up the courage to join and ask your thoughts

Thank you!
IP IP Logged
chrisrob
Senior Member
Senior Member


Joined: 01 May 2007
Online Status: Offline
Posts: 2374
Quote chrisrob Replybullet Posted: Today at 9:21am
Hi Ad and welcome to the forum.

Your Esophago-Gastro-Duodensocopy visually examined and biopsied the three areas: oesophagus, stomach and duodenum. Your histology report describes them from furthest point upwards.

An irregular z-line (junction of oesophagus and stomach) was noted. This isn't unusual, few junctions are a clean straight line. It is significant as at that area, biopsies may easily be misplaced and some gastric mucosa (stomach lining) may be mistaken for oesophageal mucosa (oesophagus lining) resulting in misdiagnosis. It could then be recorded as gastric or cardial metaplasia which in most countries (including UK) could be diagnosed as Barrett's. In USA, presence of goblet cells, defining any columnar cells biopsied as intestinal, need to be present to diagnose Barrett's.


You results show
1. Duodenum nothing unusual.
2. Stomach showed some slight gastritis - inflammation caused by acid. Using acid suppressants should give that a chance to clear. And there was no evidence of H-Pylori.
3. Lower oesophagus. Some "gastric type" mucosa seen; as suggested above this could be due to irregular z-line, but a couple of small bits of intestinal metaplasia means a trace of Barrett's. Good news it isn't dysplastic and is a very small area. It is not of significant size for that to have been noted.

Answering your specific questions:
1.The 1mm is the discrepancy of the irregular z-line not Barrett's.
2. The Seatle Protocol requires four biopsies to be taken quadrantically every 2 centimetres over its length. However, your Barrett's is not sufficient size for that being just a few dots.

You may have never noticed the usual symptoms of reflux - as many as 40% apparently don't - but you must have had it, carrying acid and bile into your lower oesophagus for the Barrett's cells to form.

Since it is such a small area, whether you have regular surveillance scopes every few years or not may depend upon you, your health insurance and your doctor. It is unlikely to ever progress if you take medication to reduce acid and reduce reflux with lifestyle.

Edited by chrisrob - Today at 9:24am
IP IP Logged
Post Reply Post New Topic
Printable version Printable version

Forum Jump
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot delete your posts in this forum
You cannot edit your posts in this forum
You cannot create polls in this forum
You cannot vote in polls in this forum