A Clinical Endoscopic and Histomorphological Evaluation of Esophageal Lesions.

Esophageal Lesions Once Thought To Be A Rare, Is Nowadays Being One Of The Common Disorder Affecting The People Throughout The World And One Among The Top Ten Malignant Neoplasms Affecting The People Of Tamilnadu, Ranking Fourth In The Gastrointestinal Tract Following Stomach, Colon And Pancreas. Twenty Percent Of Esophageal Tumors Are Benign, Mostly Leiomyomas, Remaining 80% Are Malignant Tumors In Which About 90% Are Squamous Cell Carcinoma. The Depiction Of Carcinoma Esophagus In One Of The Ancient Chinese Literature As “One Suffers In Autumn And Does Not Live To See The Coming Summer”, Is No More Considered True, Due To Recent Diagnostic And Therapeutic Advances That Have Improved The Short Term Prognosis Of These Patients. Esophageal Cancer Is A Malignancy That Is Well Known For Its Marked Variation By Geographic Area, Ethnic Group And Sex. It Is One Among The Most Dismal Of Visceral Tumors, Owing To Their Generally Advanced Stage At The Time Of Diagnosis In Developing Countries. A Prospective Study Of Patients Presenting With Dysphagia, Loss Of Weight, Anorexia, And Regurgitation Of Food Is Undertaken To Evaluate The Relationship Of This Symptom Complex To Underlying Esophageal Lesions With Special Reference To Barrett’s Esophagus. The Clinical, Endoscopic Findings And Histopathological Evaluation Of Esophageal Biopsy Specimens With Routine And Special Stains To Demonstrate The Underlying Nature Of Lesion Are Presented. Regarding The Histopathology, Previous Studies On The Pathologic Changes Of Esophageal Mucosa Induced By Gastrointestinal Reflux Disease (GERD) Has Been Mainly Focussed And Analysed. Barrett’s Esophagus (BE) Is A Premalignant Condition In Which Metaplastic Specialized Columnar Epithelium With Goblet Cells Replaces The Normal Squamous Esophageal Epithelium, Which Is Closely Associated With GERD, In Which There Is A Significant Progression From Metaplasia To Low-Grade Dysplasia To High-Grade Dysplasia And Subsequently To Adenocarcinoma. The Prevalence Of Barrett’s Esophagus In The General Population Is Difficult To Estimate Since Most Cases In The Asymptomatic Population Remain Undiagnosed. The Prevalence Is Estimated To Be About 18% And May Be High As 36%. Estimates Of Incidence Of Adenocarcinoma In Patients With Barrett’s Esophagus Vary Widely, But Barrett’s Esophagus Continuous To Be A Major Health Concern In Most Of The Western Countries Where Numerous Surveys Have Provided Information On Its Epidemiology, Diagnosis, And Surveillance Strategy. In Semiurban Areas Like Thanjavur Even Though Thought To Be Rare, The Lifestyle And Nutrition Factors With Alcohol, A Major Factor, Proves To Be Vital In The Occurrence Of Barrett’s Esophagus With Subsequent Adenocarcinoma. The Esophagectomy Specimens Subjected For Histopathological Evaluation Are Also Concentrated Towards The Histological Type, Morphological Variants, Presence Or Absence Of Changes In The Upper Gastric Region And Subsequent Dysplastic Changes At The Adjacent Mucosa. Resected Studies And Literature Closely Proves That CDC2 / CDK1, Expression In Esophageal Adenocarcinoma And Precursor Lesions Serve As A Diagnostic And Cancer Progression Marker And Role Of Cytokeratin 7/20 In The Barrett’s Esophagus. In The Present Study The Histopathological Features Of Barrett’s Esophagus Is Described In Detail Paying Particular Attention To The Presence Of Goblet Cells. In Addition, The Recent Literature Regarding Epidemiology, Clinical Features, Pathogenesis And Pathology Of Esophageal Lesions Is Reviewed