Figure 11.

Barrett’s esophagus with dysplasia. (A) Videoendoscopic image reveals a patchy mucosa consistent with SIM. (B) Histopathologic image of the biopsy specimen taken from the SCJ demonstrates intestinal metaplasia and low-grade dysplasia (H&E, orig. mag. °–2). (C) Cross-sectional OFDI image demonstrating regions consistent with SIM without dysplasia (blue arrow) and specialized intestinal metaplasia with high grade dysplasia (black arrow). (D) Expanded view of C taken from the region denoted by the blue arrow in C, demonstrating good surface maturation (arrowheads), which is consistent with SIM without dysplasia. (E) Expanded view of C taken from the region denoted by the black arrow in C, demonstrating features consistent with high grade dysplasia, including poor surface maturation (black arrowheads) and the presence of dilated glands (red arrowheads) in the mucosa. (F) A longitudinal slice highlights the transition from gastric cardia, through a 9-mm segment of specialized intestinal metaplasia and finally into squamous mucosa. Scale bars and tick marks represent 1 mm. Reprinted with permission from Suter MJ, et al. [68].