A case of the lower esophagus lined by columnar epithelium

Abstract

A 80-year-old man complained of dysphagia and substernal burning pain. X-ray examination showed a hiatus-hernia and an ulcer formation of the lower esophagus, and endoscopic examination revealed esophagitis with a deep ulcer. In the resected specimen a peptic ulcer just above the esophagogastric junctional zone was noted, and the mucosa lining of the lower esophagus was deep red in color. Histologically normal fundic glands without intestinal metaplasia were noted at the portion of cardia, and in the distal segment (ca 7 cm) of the esophagus mucosal layer was covered entirely by columnar epithelium with goblet cells. The ulcer was seen in the columnar-epithelial-lined portion just above the mucosal transitional zone. In the middle and upper esophagus normal esophageal mucosa, stratified squamous epithelium, was observed. At the portion of the squamocolumnar junction there was no stricture. These interesting findings indicate that the present case may be regarded as a type of Barrett's esophagus.