Low-grade dysplasia in Barrett's esophagus: A problematic diagnosis

Although low-grade dysplasia (LGD) in Barrett's esophagus (BE) is a histopathological diagnosis based on different histological abnormalities, it is still problematic for different reasons. Patients without confirmed diagnosis of LGD undergo unnecessary and intensified follow-up where the risk of progression is low in the majority of cases. In contrast, the presence of confirmed LGD indicates a high risk of progression. In this article we try to address these reasons focusing on re-confirmation of LGD diagnosis, interobserver agreement, and persistent confirmed LGD. The progression risk of LGD to high-grade dysplasia and esophageal adenocarcinoma will also be reviewed. (c) 2022 Elsevier Espana, S.L.U. All rights reserved.

Automated summary

The diagnosis of low-grade dysplasia (LGD) in Barrett's esophagus (BE) poses challenges and can lead to unnecessary follow-up or high-risk disease progression. This article focuses on the re-confirmation of LGD diagnosis, interobserver agreement, persistent confirmed LGD, and the risk of progression to high-grade dysplasia and esophageal adenocarcinoma.