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Updated: May 28, 2026

Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
Published on: May 11, 2014
A clinical and histopathologic focus on Barrett esophagus and Barrett-related dysplasia
Lysandra Voltaggio1, Elizabeth A Montgomery, Dora Lam-Himlin
1Department of Pathology, George Washington University Hospital, Washington, DC, USA.
Context:
Barrett esophagus is a metaplastic, premalignant lesion associated with approximately 0.5% annual incidence of progression to esophageal adenocarcinoma. Diagnosis and screening of Barrett esophagus and Barrett-related dysplasia relies on histologic evaluation of endoscopic mucosal biopsies, a process that is burdened with interobserver variability.
Objectives:
To review the histologic features and classification of Barrett esophagus and Barrett-related dysplasia, to discuss the underlying difficulties in diagnosis and pitfalls, and to provide a brief review of new developments related to therapeutic modalities for patients diagnosed with dysplasia.
Data Sources:
Sources include a review of relevant literature indexed in PubMed (US National Library of Medicine).
Conclusions:
In spite of interobserver variability, histologic assessment of dysplasia is currently the accepted method of surveillance, and subsequent patient management is dictated by this evaluation. Although not universal, endoscopic therapy is increasingly important in replacing esophagectomy for patients with high-grade dysplasia or early carcinoma.
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