Cardia-type mucosa as an esophageal metaplastic condition in children: 'Barrett esophagus, gastric mucosa-positive?'.

摘要

The term "metaplasia" is defined as a change of 1 adult cell type to another, usually as a postinjury healing phenomenon (1), and Barrett esophagus (BE) is a prototypical metaplastic condition in adults (2) and children (3,4). What type or types of mucosa should qualify as metaplastic has been a subject of considerable debate, but for many years, BE has been defined as the presence in the tubular esophagus of columnar mucosa with goblet cells containing acid mucin, occurring as a result of chronic, severe gastrointestinal reflux (5). However, the recent Montreal Global Consensus document (6) has proposed new terminology and included pure gastric cardia-type metaplasia as part of the spectrum of BE. In the context of changing concepts, 2 pediatric cases are presented in which normal squamous mucosa of the tubular esophagus was replaced by gastric cardia-type mucosa without goblet cells, and the significance of this is discussed.