​Here are two cases of a small nodule within Barrett's (top and bottom row). Of course you know that a nodule within Barrett's should ALWAYS be viewed with suspicioun. Naturally, both nodules were sampled as well as the surrounding unremarkable looking Barrett's. One case turned out to be non-dysplastic but the other were reported to harbour IMca.
WHICH NODULE IS DYSPLASTIC?
Case A (top row)
INCORRECT!
Case B (bottom row)
CORRECT!
explanation
On facebook, this proved a very difficult question and only half correctly identified Case B (bottom row) as being dysplastic.
Must admit that I felt uncomfortable about both nodules, as in my book, a nodule within Barrett's is never "right". In the end, I actually removed both. Just to be on the safe side. Incidentally, my own simple 'rule of thumb' when assessing Barrett's is as follows:
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