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Volume 117, Issue 1, Pages (July 1999)

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1 Volume 117, Issue 1, Pages 218-228 (July 1999)
The role of gastric carditis in metaplasia and neoplasia at the gastroesophageal junction  Stuart Jon Spechler  Gastroenterology  Volume 117, Issue 1, Pages (July 1999) DOI: /S (99) Copyright © 1999 American Gastroenterological Association Terms and Conditions

2 Fig. 1 (A) Photomicrograph of cardiac epithelium. Note that both the surface and tubular glands are lined almost exclusively by mucus-secreting cells. (Courtesy of Dr. Helen Wang.) (B) Photomicrograph of gastric oxyntic epithelium. Note the closely packed glands, with their numerous parietal and chief cells, opening into the gastric pits. The surface cells secrete mucus. (Courtesy of Dr. Edward Lee.) Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

3 Fig. 1 (A) Photomicrograph of cardiac epithelium. Note that both the surface and tubular glands are lined almost exclusively by mucus-secreting cells. (Courtesy of Dr. Helen Wang.) (B) Photomicrograph of gastric oxyntic epithelium. Note the closely packed glands, with their numerous parietal and chief cells, opening into the gastric pits. The surface cells secrete mucus. (Courtesy of Dr. Edward Lee.) Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

4 Fig. 2 Landmarks at the GEJ region. The SCJ (or Z-line) is the visible line formed by the juxtaposition of squamous and columnar epithelia. The GEJ is the imaginary line at which the esophagus ends and the stomach begins. The GEJ corresponds to the most proximal extent of the gastric folds and marks the proximal extent of the gastric cardia. When the SCJ is located proximal to the GEJ, there is a columnar-lined segment of esophagus. Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

5 Fig. 3 The SCJ and GEJ coincide. In this situation, the entire esophagus is lined by squamous epithelium. Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

6 Fig. 4 High-magnification photomicrograph of specialized intestinal metaplasia in Barrett's esophagus. Note that there are gastric surface-type cells (thick white arrow), intestinal-type goblet cells (curved white arrow), and cells that resemble intestinal absorptive cells with a rudimentary brush border (black arrow). (Reprinted, with permission, from the Clinical Teaching Project of the American Gastroenterological Association.) Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

7 Fig. 5 Endoscopic photograph of GEJ region showing blood-stained sites in each of four quadrants where biopsy specimens were taken across the SCJ. When these specimens were obtained, the biopsy forceps were positioned with one cup on the squamous side and the other cup on the columnar side of the SCJ. (Courtesy of Dr. Stephen Sontag.) Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions


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