Year 2017 / Volume 109 / Number 3
Original
The importance of a second opinion in the diagnosis of Barrett’s esophagus: a “real life” study

185-189

DOI: 10.17235/reed.2016.4505/2016

Vincenzo Villanacci, Marianna Salemme, Italo Stroppa, Valerio Balassone, Gabrio Bassotti,

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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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 . 4505/2016


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Publication history

Received: 22/06/2016

Accepted: 21/07/2016

Online First: 27/12/2016

Published: 28/02/2017

Article revision time: 29 days

Article Online First time: 188 days

Article editing time: 251 days


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