Slightly crowded glands
ABRUPT TRANSITION BETWEEN "NORMAL" AND "DYSPLASTIC"
"Upside down" goblet cells
REDUCED surface maturation- Larger, hyperchromatic nuclei at surface with loss of mucin
MAINTAINED NUCLEAR POLARITY (long axes of nuclei are perpendicular to basement membrane- still "pencil-like" or an orderly "picket fence")
MINIMAL nuclear membrane irregularity
Inflammation typically minimal
Sometimes presents as nodule visible at endoscopy
Some cases show crowded glands but often architecture is similar to that of nondysplastic Barrett mucosa
LOSS OF surface maturation (hyperchromatic nuclei extend all the way to the surface instead of remaining confined to base/crypt)
LOSS OF NUCLEAR POLARITY = nuclei have lost organized relationship to basement membrane
NUCLEAR MEMBRANE IRREGULARITIES
Nucleoli NOT prominent (prominent nucleoli are seen in reactive changes or indicate an invasive component is probably close by)
Occasional cases infiltrated by neutrophils
These photos were taken using pathpresenter.net, an awesome resource for learning from any of the excellent cases/ virtual slides on there.
PS: I am in no way affiliated with them, but I sure will promote them to anyone in pathology I meet.
I sure do love me some good ol' digital pathology (said in my most southern twang voice)!