1. Subsquamous Intestinal Metaplasia: Implications for Endoscopic Management of Barrett's Esophagus 
Patrick Yachimski, Gary W. Falk 
Clinical Gastroenterology and Hepatology 
Volume 10, Issue 3, Pages (March 2012)
DOI: /j.cgh
Copyright © 2012 AGA Institute Terms and Conditions

2. Figure 1
BE is defined as intestinal metaplasia of the distal esophagus, in which normal squamous epithelium (A) is replaced by columnar epithelium (B), typically following chronic gastric acid and/or duodenal bile acid reflux. SSIM can be detected in some patients with BE following long-term treatment with PPIs and either before or after endoscopic ablation therapy. SSIM may exist in the absence of endoscopically visible columnar epithelium characteristic of BE (C) or may coexist with endoscopically visible BE (D). In some instances, careful histopathologic analysis may demonstrate that SSIM connects with the mucosal surface and visible BE (E). Relatively protected from luminal acid exposure, SSIM possesses unique biologic properties compared with surface epithelium (lower panel).
Clinical Gastroenterology and Hepatology  , DOI: ( /j.cgh )
Copyright © 2012 AGA Institute Terms and Conditions

3. Figure 2
Histopathology analysis demonstrates glandular epithelium beneath squamous epithelium, consistent with SSIM or buried Barrett's; (A) 4× magnification; (B) 10× magnification.
Images courtesy of Chanjuan Shi.
Clinical Gastroenterology and Hepatology  , DOI: ( /j.cgh )
Copyright © 2012 AGA Institute Terms and Conditions