Villanacci V, Salemme M, Stroppa I, Balassone V, Bassotti G. The importance of a second opinion in the diagnosis of Barrett's esophagus: a "real life" study.
REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2016;
109:185-189. [PMID:
28026198 DOI:
10.17235/reed.2016.4505/2016]
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Abstract
BACKGROUND
Barrett's esophagus is a precancerous lesion, and its identification with the early detection of dysplasia is of paramount importance to prevent adenocarcinoma onset. However, there is still debate on the correct pathological identification of Barrett's esophagus (and of associated dysplasia), and most studies have been conducted in an experimental setting.
AIMS
To assess previous uncertain diagnoses of Barrett's (with and without dysplasia) via a second opinion of an expert pathologist in a real life setting.
PATIENTS AND METHODS
Histological sections of 32 suspected Barrett's patients from ten general Pathology units were centralized into one single unit in which an expert pathologist reviewed the slides blindly.
RESULTS
Overall, in 78% of cases there was diagnostic discordance; in particular, in 64% of cases the presence of low grade dysplasia was not confirmed. Of interest, 28% of cases with the original diagnosis were reclassified as non-Barrett's.
CONCLUSIONS
The pathological diagnosis of Barrett's esophagus, especially with regard to the presence of dysplasia, is still misinterpreted, particularly in the setting of general Pathology units. Thus, a second opinion from an experienced pathologist may help in the interpretation of the results and in starting appropriate follow-up programs.
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