babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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the problem is that in Goljan pathology and another pathology - it is GASTRIC TYPE columnar cells and INTESTINE TYPE Goblet cells
i am confused
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| babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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FA also says that it's GASTRIC type metaplasia, but in QB it was intestinal
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| me007
Forum Guru
Topics: 72
Posts: 799
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it is glandular metaplasia.
all q banks have some bizarre questions
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| babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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i read exactly the same explanation in Patho, but problem was - i had to make a choice between GASTRIC and INTESTNAL...hhhhhhhhhhhhhhhhhhhh
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| babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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this question drives me NUTS!
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| Ancylostoma
Forum Guru
Topics: 42
Posts: 637
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Its called intestinal metaplasia. The conversion of the normally stratified squamous epithelium to a simple columnar epithelium with goblet cells of intestitinal origin. I have had to choose before on questions and went with intestinal. Check the robbins section on this, it explains it as intestinal metaplasia(to my recollection) and may help with your frustration.
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| new_n_lost
Forum Hero
Topics: 663
Posts: 6,107
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Yes its intestinal metaplasia fomerly known as specialized columnar epithelial which is currently the definitive diagnostic point for Barret's.
REFERENCE: http://www.emedicine.com/med/topic210.htm
Finally, in 1976 Paull et al published a report on the histologic spectrum of BE in which they used manometric guidance for their biopsies. These patients had 1 or a combination of 3 types of columnar epithelium��"a gastric fundic-type, a junctional type, and a distinctive type of intestinal metaplasia the investigators called "specialized columnar epithelium." This specialized intestinal metaplasia (SIM), complete with goblet cells, has become the sine qua non for the diagnosis of BE. While the histologic lesion became clearly evident, the endoscopic definition of BE has continued to change over the past 25 years. Many people believed that the distal esophagus could contain a normal region of columnar mucosa. In addition, determining the exact location of the esophagogastric junction (EGJ) in patients with BE often is difficult. To avoid false-positive diagnoses, investigators selected arbitrary lengths of columnar-lined esophagus to establish a diagnosis for their studies. Eventually, community endoscopists embraced this practice and biopsy of this so-called normal distal columnar-lined esophagus was avoided. The last 10 years have brought convincing evidence that SIM, the hallmark histologic lesion of BE, predisposes to dysplasia and cancer regardless of the endoscopic location. Thus, the definition of BE currently is the finding of SIM anywhere within the tubular esophagus
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