Goblet cell mimickers in esophageal biopsies are not associated with an increased risk for dysplasia

Mamoun Younes, Atilla Ertan, Gulchin Ergun, Ray Verm, Margaret Bridges, Karen Woods, Frank Meriano, A. Carl Schmulen, Ronald Colman, Craig Johnson, Alberto Barroso, Jim Schwartz, John McKechnie, Juan Lechago

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Context.-Identification of intestinal-type goblet cells (ITGCs) in hematoxylin-eosin-stained sections of esophageal biopsies is essential for the diagnosis of Barrett metaplasia. However, we have seen cases diagnosed as Barrett metaplasia based solely on cells that pose morphologic similarity to ITGCs on hematoxylin-eosin staining or stain positive with Alcian blue. Objective.-To determine the clinical significance of goblet cell mimickers. Design.-Initial biopsies from 78 patients with original diagnosis of Barrett metaplasia negative for dysplasia and a mean follow-up of 72 months were reviewed and reclassified into 3 categories: (1) ITGCs, (2) goblet cell mimickers, or (3) neither. Sections from available paraffin blocks were stained with Alcian blue at pH 2.5. The presence of the different types of cells and positive Alcian blue staining were correlated with each other and evaluated for their significance as predictors of progression to dysplasia. Results.-Goblet cell mimickers were present in 35 cases and were associated with ITGCs in the same biopsy in 23 (66%) of these cases. Intestinal-type goblet cells were present in 56 cases, and the remaining 10 cases, although called Barrett on the original report, did not show either ITGCs or goblet cell mimickers. Only the presence of ITGCs was associated with significant risk for dysplasia (P = .008). Positive Alcian blue staining was not associated with a significant risk for dysplasia. Conclusions.-Our results indicate that the diagnosis of Barrett metaplasia should be rendered with confidence only when ITGCs are identified on routine hematoxylin-eosin-stained sections.

Original languageEnglish (US)
Pages (from-to)571-575
Number of pages5
JournalArchives of Pathology and Laboratory Medicine
Volume131
Issue number4
StatePublished - Apr 2007

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

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