Barrett’s oesophagus (Columnar lined oesophagus)-Normal squamous lining has been replaced by a metaplastic columnar epithelium which is visible macroscopically. In order to make a positive diagnosis of “Barrett’s oesophagus”, a segment of columnar metaplasia of any length must be visible endoscopically above the oesophago-gastric junction and confirmed or corroborated histologically.
- Diagnostic of CLO – Native oesophageal structures with metaplastic glandular mucosa, +/-intestinal metaplasia.
- Biopsies corroborative of an endoscopic diagnosis of CLO – Intestinalised metaplastic glandular mucosa with no evidence of native oesophageal structures. This could potentially still represent incomplete intestinal metaplasia in the stomach, especially in a hiatus hernia or IM at the cardia.
- Biopsies in keeping with, but not specific for CLO- Gastric type mucosa of either fundic or cardic type without IM. Patchwork appearance is still possible, as is a non-organised arrangement. Such appearances could, however, represent the OG junction or the stomach, with or without hiatal hernia.
- Biopsies without evidence of CLO – Oesophageal type squamous mucosa with no evidence of glandular epithelium.
British Society of Gastroenterology. Guidelines for the diagnosis and management of columnar lined Barrett’s oesophagus.