In Barrett esophagus, goblet cell-containing intestinal-type epithelium replaces the normal squamous epithelium in which segment of the esophagus?

In Barrett esophagus, goblet cell-containing intestinal-type epithelium replaces the normal squamous epithelium in which segment of the esophagus?

• A. Proximal esophagus
• B. Mid esophagus
• C. Distal esophagus
• D. Entire esophagus

Answer: (C)

Barrett esophagus arises when chronic reflux exposure prompts the normal squamous lining of the distal esophagus to convert into a columnar, goblet-cell–containing intestinal type epithelium. This metaplasia occurs where refluxate most actively contacts the mucosa—the distal esophagus at the gastroesophageal junction—so goblet cells replace squamous epithelium there. The proximal and mid portions are less exposed to reflux and thus typically remain squamous; involvement of the entire esophagus would be unusual. The presence of goblet cells marks Barrett’s and carries an increased risk of progression to dysplasia and adenocarcinoma.

Barrett esophagus arises when chronic reflux exposure prompts the normal squamous lining of the distal esophagus to convert into a columnar, goblet-cell–containing intestinal type epithelium. This metaplasia occurs where refluxate most actively contacts the mucosa—the distal esophagus at the gastroesophageal junction—so goblet cells replace squamous epithelium there. The proximal and mid portions are less exposed to reflux and thus typically remain squamous; involvement of the entire esophagus would be unusual. The presence of goblet cells marks Barrett’s and carries an increased risk of progression to dysplasia and adenocarcinoma.