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Crypt dysplasia on Barrett's oesophagus
  1. Francisco Baldaque-Silva1,
  2. Margarida Marques1,
  3. Joanne Lopes2,
  4. Fatima Carneiro3,
  5. Michael Vieth4,
  6. Guilherme Macedo1
  1. 1Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
  2. 2Pathology Department, Centro Hospitalar São João, Porto, Portugal
  3. 3Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
  4. 4Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
  1. Correspondence to Dr Francisco Baldaque-Silva, Gastroenterology Department, Centro Hospitalar São João, Portugal, Alameda Prof. Hernâni Monteiro 34, Porto 4200–319, Portugal; fbaldaquesilva{at}

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In a study by Sharma et al1 recently published in Gut, high-definition endoscopy and narrow band imaging (NBI) enabled detection of more areas of dysplasia than Seattle protocol. In addition, regular mucosa did not harbour high-grade dysplasia (HGD)/cancer, leading to the suggestion that biopsies could be avoided in those areas.

However, authors stated in the discussion that the routine use of NBI targeted biopsies for detection of HGD/cancer should not be recommended. To highlight this point, we would like report a case of a C10M12 Barrett's oesophagus (BO) patient with two previous macroscopic lesions with HGD and adenocarcinoma resected using multiband mucosectomy (figure 1). In a careful follow-up using the same endoscope as in the reported study,1 no macroscopic lesions were detected and biopsies were performed according to Seattle protocol. The pathological analysis …

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