By Laura Lamps MD, Andrew Bellizzi MD, Wendy L. Frankel MD, Scott R. Owens MD, Rhonda Yantiss MD
nearly 20 million gastrointestinal tract biopsies are played every year within the usa. whereas a lot of those are straight forward, a few are histologically refined or contain a posh differential prognosis. This concise visible consultant to the total variety of neoplastic gastrointestinal specimens offers the working towards pathologist or trainee with a transparent research and analysis of either universal and in all probability deceptive variations of sickness. The authors hide the total tubular GI tract with over six hundred top of the range photographs and a concise description of the most important positive factors of every entity: definitions and terminology, gross and morphologic positive factors, differential diagnoses, important ancillary exams, staging and grading parameters, and specific medical issues. photographs depict differential prognosis positive aspects, usually visible editions which could in all probability result in misclassification or misdiagnosis, and correlated molecular and immunologic strategies.
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" nearly 20 million gastrointestinal tract biopsies are played every year within the usa. whereas a lot of those are basic, a few are histologically sophisticated or contain a posh differential analysis. This concise visible consultant to the total variety of neoplastic gastrointestinal specimens offers the working towards pathologist or trainee with a transparent research and prognosis of either universal and in all likelihood deceptive versions of affliction.
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Additional info for Neoplastic Gastrointestinal Pathology
The minor papilla in the duodenum can show the same histologic appearance as heterotopic pancreas, with surface intestinal epithelium undermined by submucosal pancreatic tissue. Most diseases of the pancreas, including pancreatic intraepithelial neoplasia and carcinoma, have been rarely reported arising from ectopic pancreas. 6 Endometriosis can be a major pitfall in the diagnosis of epithelial neoplasia. This example of endometriosis near the mucosal surface shows mucin-depleted cells with enlarged nuclei that mimic dysplastic crypts (A–B), but there is surrounding endometrial-type stroma.
The tumor cells were positive with CK AE1/3 (B) and vimentin (C), supporting the diagnosis of a sarcomatoid carcinoma. 2 Approach to Epithelial Neoplasms of the Gastrointestinal Tract of CK AE1/3 and vimentin suggests that the tumor is a carcinoma with sarcomatous differentiation (ie, sarcomatoid carcinoma). Further examination of the tumor identified a small area of poorly formed glands, further supporting the diagnosis. The preceding three cases illustrate that using an algorithmic approach when evaluating epithelial and epithelioid lesions of the GI tract is helpful in establishing a differential diagnosis that can be evaluated systematically, thus helping to avoid pitfalls.
5 This metastatic colonic adenocarcinoma undermines the small bowel mucosa. This is a typical growth pattern for a metastasis to the GI tract (A). Metastatic poorly differentiated gastric adenocarcinoma infiltrates between benign rectal glands (B). Metastatic adenocarcinoma involving the mucosa and surface epithelium of the small bowel mimics carcinoma in situ (C). Neoplastic Gastrointestinal Pathology: An Illustrated Guide 24 basement membrane and the presence of an apparent adenoma cannot be assumed to be definite evidence of a primary neoplasm for similar reasons.