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WHO Classification of Tumours
Glandular intraepithelial neoplasia, high grade
Esophagus


Definition

Intraepithelial neoplasia is defined as non-invasive cytological or architectural alterations that may lead to the development of invasive carcinoma. The traditional term dyplasia refers to the the presence of morphological features of neoplasia
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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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The development of oesophageal adenoarcinoma is a multistep process, progressing from normal glandular epithelium to intraepithelial neoplasia (dysplasia), and eventually to invasive carcinoma

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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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High-grade intraepithelial neoplasia (dysplasia) is histologically characterized by neoplastic glandular cells that are usually cuboidal, rather than columnar, with a high nucleus to cytoplasm ratio, prominent amphophilic nucleoli, more pronounced architectural disarray and brisk mitotic activity

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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



. The nuclei often extend into the luminal aspect of the cell, and nuclear polarity is usually lost.

> Barrett oesophagus
This change of the oesophageal mucosa due to gastro-oesophageal reflux is characterized by intestinal metaplasia and constitutes the most important precursor lesion for oesophageal adenocarcinoma.

Commentary: Preneoplastic lesions of the digestive system