Another Major Presence for Inform Diagnostics
Washington, D.C. - For the past four years, the conspicuous presence of researchers from
Inform Diagnostics has become a tradition at the annual meeting of the
American College of Gastroenterology. This year was no exception: Fifteen
abstracts were selected for poster presentation, a number that compares
favorably with the most prestigious academic gastroenterology and pathology
departments in the United States. One of these posters (see below for
details) was honored with the ACG Presidential Poster Award.
This year, Inform Diagnostics researchers focused their efforts on several
areas: infections, neoplasia, diarrhea, gastritis, and eosinophilic esophagitis.
In a highly innovative study and winner of the ACG Presidential Poster Award,
Ray discovered that young women (<40 years of age) with collagenous colitis
are eight times more likely than the general population to have celiac
disease. Therefore, these authors suggest that such patients should also
have an EGD with duodenal biopsies to exclude concurrent celiac disease.
As part of an ongoing effort to determine the temporal and geographic trends
of reactive gastropathy, a condition of the gastric mucosa related to
bile reflux and possibly to the use of NSAIDs that appears to be increasing
Genta (in collaboration with I Maguilnik of the University of Rio Grande do
Sul in Porto Alegre, Brazil) examined the demographic and epidemiologic
patterns of this condition and concluded that it has been increasing in
frequency in the last few years, that it is emerging in children and young
people, and that its prevalence is not as inversely related to the prevalence
of H. pylori as previously believed. In collaboration with J Hurrell (University
of Texas Southwestern) and A Sonnenberg (University of Oregon)
Genta showed that, contrary to previous suggestions derived from smaller series,
there was no evidence of monthly or seasonal variation even within regions
with variable climates among 10,000 patients with eosinophilic esophagitis.
While it has been shown that H. pylori gastritis is inversely correlated
with Barrett’s esophagus,
Trapasso took this concept one step further and showed that H. pylori infection
seems to also protect from dysplasia occurring in Barrett’s mucosa.
In contrast, there is a positive correlation with squamous cell carcinoma,
possibly because of shared risk factors.
McIntyre, who has a long-standing interest in the diagnosis of Barrett’s
esophagus, presented a study on the controversial issue of focal intestinal
metaplasia at the gastroesophageal junction. She concluded that, in order
to meet AGA guidelines for the diagnosis of Barrett’s esophagus,
the pathologist must be aware of the endoscopic impression at the time
In three separate studies,
Saboorian and his colleagues (Lindberg,
Kinsey) examined the prevalence of unexpected infections in gastrointestinal
biopsy specimens and concluded that, although exceedingly rare, colonic
amebiasis, spirochetosis, and herpes esophagitis occur in immunocompetent
patients. Since these patients usually present with non-specific symptoms
and minimal organism loads, the diagnosis rests on the pathologist’s
ability to consider rare, often neglected entities, and to be perseverant
in the search for an etiology that can elucidate the origin of otherwise
unexplained inflammatory changes.
Yang devoted two projects to the investigation of the distribution patterns
of colorectal adenomas and carcinomas; he and his colleagues (SJ Tang
and R Wu of the University of Mississippi; and J Yang, from the Medical
College of Wisconsin) determined that the distribution of colonic adenocarcinoma
shares similar patterns with its precursors, but that its left-sided predominance
gradually diminishes and shifts to the right side with advancing age,
particularly in women.
Golembeski focused on unexpected signet ring carcinomas that may be found in biopsy
specimens from otherwise benign-appearing areas of the stomach. Two studies
were devoted to diarrheal diseases. After examining colonic biopsy sampling
patterns in more than 100,000 patients with diarrhea,
Genta concluded that representative, topographically defined mucosal sampling
is paramount in helping pathologists reach etiology-specific diagnoses
in these patients.
In addition to these systematic studies (some of which have already been
submitted as full papers at the time of this writing) there were several
case reports: “Gastric Clear Cell Carcinoid Tumor in a Patient with
Von Hippel-Lindau Disease” and “Metastatic Breast Carcinoma
to the Colon Mimicking Microscopic Colitis” (both by
Bedeir) as well as a clinicopathologic study of four adults with autoimmune enteropathy (Kinsey,
– Robert M. Genta, MD, Chief for Academic Affairs