Barrett's Esophagus of long segment (23 of 24)

Alcian Blue Stains.

There is ectopic gastric mucosa with incomplete intestinal
metaplasia , with goblet cells (alcian blue)
The diagnosis of Barrett’s esophagus requires both
endoscopic and histologic evidence of metaplastic columnar
epithelium. Endoscopically, there must be columnar
epithelium within the esophagus. Histologically, the
epithelium must be metaplastic, as defined by the presence
of goblet cells. An Alcian blue stain at pH 2.5 stains the
acidic mucin present in the goblet cells. The most common
errors in the identification of goblet cells are:
1) "pseudogoblet" cells; and 2) Alcian blue positive cells
that are not goblet cells.
Pseudogoblet cells are barrel-shaped gastric surface or
foveolar cells that do not stain with Alcian blue. These cells
commonly have a blush of eosinophilia, due to neutral
mucin, on H&E stained sections, in contrast to the blush of
basophilia, imparted by the acidic mucin in goblet cells.