A Practical Approach to Small Round Cell Tumors Involving the Gastrointestinal Tract and Abdomen
This article reviews the spectrum of small round cell sarcomas wit hin the gastrointestinal tract and abdomen. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - July 11, 2023 Category: Pathology Authors: Khin Thway, Cyril Fisher Source Type: research
Deep Learning and Colon Cancer Interpretation
The rapidly evolving development of artificial intelligence (AI) has spurred the development of numerous algorithms that augment information obtained from routine pathologic review of hematoxylin and eosin-stained slides. AI tools that predict prognosis and underlying molecular alterations have been the focus of much of the research to date. The results of these studies highlight the tremendous potential of AI to enhance our pathology reports by providing rapid predictions of key features that influence therapy and outcomes. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - June 26, 2023 Category: Pathology Authors: Kelsey McHugh, Rish K. Pai Source Type: research
Histopathologic Manifestations of Immune Checkpoint Inhibitor Therapy-Associated Gastrointestinal Tract Injury
Immune checkpoint inhibitors have revolutionized the management of many advanced cancers by producing robust remissions. They mostly target two immune regulatory pathways: cytotoxic T lymphocyte antigen-4 and programmed death-1 or its ligand. However, a flip side is the immune-related adverse events (irAEs) commonly affecting the gastrointestinal (GI) tract that can cause treatment interruptions or discontinuation. This practical review discusses the clinical and histopathologic findings of irAEs encountered in the luminal GI tract, along with histopathologic differentials that can mimic varied inflammatory, infectious, or...
Source: Surgical Pathology Clinics - June 26, 2023 Category: Pathology Authors: James Michael Mitchell, Dipti M. Karamchandani Source Type: research
Lymphomas and Amyloid in the Gastrointestinal Tract
Lymphoproliferative disorders are a heterogeneous group of neoplasms with varying clinical, morphologic, immunophenotypic, and genetic characteristics. A subset of lymphomas have a proclivity for the gastrointestinal tract, although this region may also be involved by systemic lymphomas. In addition, a number of indolent lymphoproliferative disorders of the gastrointestinal tract have been defined over the past decade, and it is important to accurately differentiate these neoplasms to ensure that patients receive the proper management. Here, the authors review lymphoid neoplasms that show frequent gastrointestinal involvem...
Source: Surgical Pathology Clinics - June 26, 2023 Category: Pathology Authors: Alisha D. Ware, Laura M. Wake, Yuri Fedoriw Source Type: research
Challenges in Diagnosing and Reporting Cholangiocarcinoma
Intrahepatic cholangiocarcinoma is a challenge to the practicing surgical pathologist for several reasons. It is rare in many parts of the world, and thus practical exposure may be limited. Related to the fact of its rarity is the fact that more common tumors which frequently metastasize to the liver can be morphologically indistinguishable (eg, pancreatic ductal adenocarcinoma). Immunohistochemical testing is generally non-contributory in this context. Other difficulties arise from the protean morphologic manifestations of cholangiocarcinoma (ie, small duct vs. large duct) and the existence of combined cholangiocarcinoma ...
Source: Surgical Pathology Clinics - June 23, 2023 Category: Pathology Authors: Tony El Jabbour, Attila Molnar, Stephen M. Lagana Source Type: research
What Therapeutic Biomarkers in Gastro-Esophageal Junction and Gastric Cancer Should a Pathologist Know About?
Malignancies of upper gastrointestinal tract are aggressive, and most locally advanced unresectable and metastatic cancers are managed by a combination of surgery and neoadjuvant/adjuvant chemotherapy and radiotherapy. Current therapeutic recommendations include targeted therapies based on biomarker expression of an individual tumor. All G/gastro-esophageal junction (GEJ) cancers should be tested for HER2 status as a reflex test at the time of diagnosis. Currently, testing for PDL 1 and mismatch repair protein status is optional. HER2 testing is restricted to adenocarcinomas only and endoscopic biopsies, resections, or cel...
Source: Surgical Pathology Clinics - June 23, 2023 Category: Pathology Authors: Marian Priyanthi Kumarasinghe, Daniel Houghton, Benjamin Michael Allanson, Timothy J. Price Source Type: research
Characteristics, Reporting, and Potential Clinical Significance of Nonconventional Dysplasia in Inflammatory Bowel Disease
The term nonconventional dysplasia has been coined to describe several underrecognized morphologic patterns of epithelial dysplasia in inflammatory bowel disease (IBD), but to date, the full recognition of these newly characterized lesions by pathologists is uneven. The identification of nonconventional dysplastic subtypes is becoming increasingly important, as they often present as invisible/flat dysplasia and are more frequently associated with advanced neoplasia than conventional dysplasia on follow-up. This review describes the morphologic, clinicopathologic, and molecular characteristics of seven nonconventional subty...
Source: Surgical Pathology Clinics - June 23, 2023 Category: Pathology Authors: Won-Tak Choi Source Type: research
Gastrointestinal Biopsies in the Patient Post-Stem Cell Transplant
Graft-versus-host disease (GVHD) is a major complication of hematopoietic stem cell transplantation (SCT), leading to a significant morbidity and mortality. Histologically, gastrointestinal GVHD is characterized by crypt apoptosis and dropout. However, similar histologic features can also be seen in drug-induced injury and opportunistic infection. Knowledge of the timing of biopsy, patient medications, evidence of infection, and presence of GVHD at other organ sites can aid in the correct diagnosis and subsequent management of these patients. This review focuses on the pathologic differential diagnosis of apoptosis in gast...
Source: Surgical Pathology Clinics - June 20, 2023 Category: Pathology Authors: Tao Zhang, Catherine E. Hagen Source Type: research
Mast Cell Disorders of the Gastrointestinal Tract
Pathologists are increasingly asked to evaluate mast cell infiltrates in the gastrointestinal tract when there is clinical concern for systemic mastocytosis or a variety of functional disorders, including irritable bowel syndrome and mast cell activation syndrome. Neoplastic mast cells have established quantitative, morphologic, and immunohistochemical features that facilitate their identification in gastrointestinal mucosal biopsies. Specific qualitative and quantitative findings are lacking for inflammatory mast cell –mediated disorders. This review covers histopathologic features of mast cell disorders that affect the...
Source: Surgical Pathology Clinics - June 20, 2023 Category: Pathology Authors: Nicole C. Panarelli Source Type: research
Infectious Disease Pathology of the Gastrointestinal Tract
Infectious diseases of the GI tract mimic a variety of other GI diseases, including chronic idiopathic inflammatory bowel disease and ischemia. It can be challenging to identify pathogens in tissue sections as well, as many trainees are not exposed to infectious disease pathology other than in the context of microbiology. Our ability to diagnose infections in formalin fixed, paraffin embedded material has grown exponentially with the advent of new histochemical and immunohistochemical stains, as well as more options for molecular testing. Correlating these diagnostic techniques with morphology has led to increasing underst...
Source: Surgical Pathology Clinics - June 20, 2023 Category: Pathology Authors: Laura W. Lamps Source Type: research
How Hepatologists Use Liver Biopsy in the Evaluation of Liver Disease?
This article focuses on how hepatologists view the role of liver biopsy in diagnosis, assessment, and management of chronic and acute liver disease, and its variable use among different etiologies of liver disease and in the evaluation of liver fibrosis. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - June 11, 2023 Category: Pathology Authors: Emilie K. Mitten, Anna Rutherford Source Type: research
Liver Pathology Related to Onco-Therapeutic Agents
Oncotherapeutic agents can cause a wide range of liver injuries from elevated liver functions tests to fulminant liver failure. In this review, we emphasize newer generation of drugs including immune checkpoint inhibitors, protein kinase inhibitors, monoclonal antibodies, and hormonal therapy. A few conventional chemotherapy agents are also discussed. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - June 11, 2023 Category: Pathology Authors: Paige H. Parrack, Stephen D. Zucker, Lei Zhao Source Type: research
Mesenchymal Neoplasms of the Liver
Mesenchymal neoplasms of the liver can be diagnostically challenging, particularly on core needle biopsies. Here, I discuss recent updates in neoplasms that are specific to the liver (mesenchymal hamartoma, undifferentiated embryonal sarcoma, calcifying nested stromal-epithelial tumor), vascular tumors of the liver (anastomosing hemangioma, hepatic small vessel neoplasm, epithelioid hemangioendothelioma, angiosarcoma), and other tumor types that can occur primarily in the liver (PEComa/angiomyolipoma, inflammatory pseudotumor-like follicular dendritic cell sarcoma, EBV-associated smooth muscle tumor, inflammatory myofibrob...
Source: Surgical Pathology Clinics - June 11, 2023 Category: Pathology Authors: David J. Papke Source Type: research
What ’s Coming Down the Tube: Current and Emerging Topics in Gastrointestinal Pathology
To make this issue a high value to readers, I collaborated with an august group of expert pathologists to address timely current and emerging topics in gastrointestinal pathology. It was a great privilege to work with them, and they have my gratitude for well-written articles that address two categories of top-of-mind topics: select everyday issues and key emerging issues. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - June 11, 2023 Category: Pathology Authors: Rondell P. Graham Tags: Preface Source Type: research
Systemic Disease and the Liver Part 2
The liver is involved in many multisystem diseases and commonly may manifest with abnormal liver chemistry tests. The liver test perturbations may be multifactorial in nature, however, as patients are receiving many different medications and can also have intrinsic liver disease that may be exacerbated by the systemic disorder. Some disorders have typical histologic findings that can be diagnosed on liver biopsy, whereas others will show a more nonspecific histology. Clinicians should be aware of these conditions so as to consider the performance of a liver biopsy at the most opportune time and setting to help establish th...
Source: Surgical Pathology Clinics - June 9, 2023 Category: Pathology Authors: Maria Isabel Fiel, Thomas D. Schiano Source Type: research
