Histology of the Gastroesophageal Junction

Chandrasoma, Parakrama; Der, Roger; Ma, Yanling; Dalton, Patricia; Taira, Mark

doi:10.1097/00000478-200003000-00009

Cited by 281 publications

(180 citation statements)

References 9 publications

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“…Some investigators believe that cardiac mucosa is not normal mucosa but, rather, mucosa acquired as a result of gastroesophageal reflux [10]. Gastroesophageal reflux disease (GERD) occurs less frequently in Japan than in the Western world, but in our study, cardiac mucosa was seen in most patients.…”

Section: Discussioncontrasting

confidence: 63%

Mucin phenotypic expression and background mucosa of esophagogastric junctional adenocarcinoma

et al. 2004

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Section: Discussioncontrasting

confidence: 63%

Mucin phenotypic expression and background mucosa of esophagogastric junctional adenocarcinoma

et al. 2004

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“…The concept of the normality of cardiac mucosa has been challenged by Chandrosoma and associates (115,116). They studied the gastroesophageal junction region in unselected adult autopsies and found that when one section was taken through this region, 29% of cases had no cardiac or cardiofundic mucosa, 44% of cases had cardiofundic mucosa only, and only 29% of cases had a zone of pure cardiac mucosa.…”

Section: Status Of the Cardiac Mucosa-does It Exist?mentioning

confidence: 99%

Gastritis and Carditis

Owen

2003

Modern Pathology

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Dyspepsia is a common clinical problem. Its causes include peptic ulcer disease, gastroesophageal reflux, and functional (nonulcer) dyspepsia. A detailed clinical description of pain does not reliably differentiate the cause. Approximately 80% of gastroscopies are performed for the investigation of dyspepsia. "Gastritis" is diagnosed endoscopically in 59% of all stomachs, although in only 3% are the changes severe. Pathologic examination of unselected gastric biopsy specimens reveals that abnormalities are present in 62-73%, but there is only a weak correlation between endoscopic and histologic findings. For these reasons, it is recommended that endoscopic examination should always be accompanied by biopsy. Ideally, biopsies should be taken in a systematic fashion to include sampling of antrum and corpus. Recent evidence suggests that gastric infection by Helicobacter pylori initially presents as a superficial gastritis. Later it may become atrophic with development of intestinal metaplasia. The onset of atrophic changes may be related to the duration of infection, the strain of the infecting organism, associated dietary factors, or as-yet undefined host factors related to immunity. Persistent superficial gastritis predisposes to duodenal ulcer and gastric mucosa-associated lymphoid tissue lymphoma. Atrophic gastritis predisposes to gastric ulcer and adenocarcinoma. Evidence is accumulating that in some patients, pernicious anemia may be an end result of H. pylori-induced atrophic gastritis. Reactive gastropathy is a relatively common finding in gastric biopsies; in most instances it is associated with either reflux of duodenal contents or therapy with nonsteroidal anti-inflammatory drugs. Lymphocytic gastritis, eosinophilic gastritis, and the gastritis associated with Crohn's disease are distinct morphologic entities. Most gastroscopies are performed for the investigation of dyspepsia (1-7). This is a common clinical problem but is rarely life-threatening. The causes of dyspepsia include peptic ulcer disease (30%), gastroesophageal reflux (29%), and nonulcer (functional) dyspepsia (40%). The cause of functional dyspepsia is unclear at the present time, although in many instances it may be related to abnormalities of gut motility. In Ͻ1% of cases is gastric cancer a cause of dyspepsia. A detailed description of the symptoms of dyspepsia does not reliably differentiate the cause, although the presence of heartburn strongly suggests a component of gastroesophageal reflux. Correlations among patient symptoms, endoscopic appearances, and biopsy findings of gastritis are imperfect (4 -6). Agreement is best in cases where peptic ulcer or another focal lesion is identified. A study by Khakoo et al. (7) from the United Kingdom illustrates the problems encountered. Endoscopic and histologic findings were reviewed in 167 patients who underwent gastroscopy for dyspeptic symptoms. Of these, 98 patients (57%) had endoscopic evidence of gastritis. In 42% of patients, gastritis involved the antrum alone, in 7% it involved the...

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“…14,15 For OCT to be a reliable, sensitive, and cost-effective screening instrument, characterization of epithelial architecture at the SCJ should be accurate enough to distinguish premalignant (SIM) from benign tissue. The aim of this study was to identify and validate OCT image criteria of SIM, permitting its distinction from nonmetaplastic tissue at the gastroesophageal junction.…”

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confidence: 99%