Staining pattern interpretation in
Barrett epithelium can be problematic in certain instances, and adequate assessment relies on proper biopsy orientation with clear identification of both surface epithelium and deep glands and correlation with the hematoxylin-eosin stain to ensure presence of IM and absence of dysplasia.
Lomo and colleagues, (8) using microdissection, immunohistochemical, molecular techniques, showed that what they called basal crypt dysplasia-like atypia was similar to conventional LGD and HGD rather than to nondysplastic
Barrett epithelium. However, clinical follow-up was not available for the patients in that article, so the clinical significance remained unknown.