Barrett's epithelium complicating lye ingestion with sparing of the distal esophagus.

We report a patient with a history of lye ingestion in whom a band of ectopic gastric mucosa is associated with a stricture of the mid-esophagus. Specialized columnar epithelium (a type of Barrett's epithelium) developed along the edges of this band. This specialized columnar epithelium is separated from the mucosa of the stomach by a continuous sheet of normal stratified squamous epithelium. Heretofore, Barrett's epithelium involving the middle esophagus has been reported only as the proximal extension of a sheet of columnar mucosa lining the entire distal esophagus. The development of specialized columnar epithelium in this setting suggests that local factors besides gastroesophageal reflux may be involved in the pathogenesis of Barrett's epithelium.