Blog Posts in December 2013

Part 1—Upper GI tract Optimal biopsy sampling will help your expert Inform Diagnostics GI Pathologist to render a specific and accurate diagnosis. In the gastrointestinal tract, it is often important to sample normal-appearing as well as abnormal-appearing mucosa, as many disorders are ...

There are many quality-control measures and programs in place at Inform Diagnostics Life Sciences that complement our expertise, ensure the highest quality, and promote the most accurate diagnoses. Among them is the intradepartmental consultation. When a pathologist encounters a difficult case, an ...

Helicobacter -negative chronic active gastritis is a histopathologic entity characterized by diffuse chronic active inflammation in a pattern typically encountered in H. pylori gastritis, but with no organisms detectable by conventional histology or immunohistochemical staining. View the poster ...

Gastric cancer is associated with substantial morbidity and mortality worldwide. It is the second most common cause of cancer-related deaths globally.1 In the United States, the majority of patients with gastric cancer present with advanced, metastatic, or inoperable disease, and typically require ...

We have previously reported, and others have confirmed, an inverse relationship between eosinophilic esophagitis and Helicobacter pylori gastritis. Other conditions affecting the stomach can include reactive gastropathy, autoimmune atrophic gastritis, chronic inactive gastritis, and intestinal ...

The rates of primary and secondary syphilis have been increasing in the United States since 2001, following a historic low in 2000. The manifestations of syphilis as a genital disease are well described; however, its presentation as primary anal canal disease remains relatively unexplored. Although ...

As pathologists, diagnostic excellence is always our goal. Even so, we are often stymied by differences in terminology, inconsistent application of microscopic criteria and insufficient large-scale studies. These differences make it difficult to answer important questions in pathology. A good ...

Low-grade dysplasia in Barrett’s esophagus is overdiagnosed. Studies have shown that Barrett’s mucosa with low-grade dysplasia is significantly over-diagnosed.[1] In one study, 12.2% of Barrett’s patients were diagnosed with low-grade dysplasia. However, only 1.8% of all ...

When faced with a patient with possible celiac disease, a physician has the option to conduct several tests, including a blood test to look for gluten antibodies and nutritional deficiencies, a stool test to check for signs of malabsorption, and an endoscopy to visualize the small intestine for ...

Eosinophilic esophagitis (EoE) is a condition that causes swallowing problems, particularly in younger patients. EoE, which is believed to result from allergic processes, has dramatically increased in frequency in the last decade, but the reasons for this increase remain unknown. After a series of ...

The Inform Diagnostics DNA mismatch repair (MMR) gene mutation screening program for Lynch Syndrome was initiated in March 2010, with the objective of testing not only all newly diagnosed colorectal adenocarcinomas, but also high-grade precancerous polyps (adenomas with high grade dysplasia) and ...

Focal active colitis (FAC) is a histologic pattern of injury, not a specific diagnosis. From a morphologic standpoint, FAC is defined either as a single focus of neutrophilic crypt injury (cryptitis) or as multiple separate foci of cryptitis occurring in different pieces of tissue within the same ...

Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic disease thought to arise from an allergy/immune-mediated process. Reports of patients with EoE and concurrent inflammatory bowel disease (IBD) have suggested that there might be an association between these two conditions. However, ...

We identified several cases in which a histopathologic diagnosis of Candida esophagitis was made in a patient with no known risk factors and an esophagus specifically described as endoscopically normal. A diagnosis of Candida esophagitis in such patients tended to generate questions from the ...

Intestinal spirochetosis is a condition in which the colonic mucosa is colonized by anaerobic spirochetes, either Brachyspira aalborgi or Brachyspira pilosicoli. Intestinal spirochetosis is generally associated with immunocompromised states such as Human Immunodeficiency Virus (HIV) infection, but ...

Microscopic colitis (MC) is a condition that includes a spectrum of histological abnormalities of the colonic mucosa, ranging from an increase in the number of intraepithelial lymphocytes (IELs) (‘‘lymphocytic colitis’’, or LC) to a diffuse lymphoplasmocytic infiltrate of the ...

Thirty years after its discovery, Helicobacter pylori remains the world’s most common infectious agent, with an estimated prevalence ranging from less than 5% in Northern European children to more than 80% in certain underprivileged populations in Asia, Africa, and Latin America. View the ...

European studies have shown that long-term proton-pump inhibitor (PPI) therapy in patients with GERD and antrum-predominant (AP) gastritis may induce a proximal shift of both bacteria and inflammation, resulting in corpus-predominant (CP) gastritis and acceleration of atrophy. In the US it is ...

Mutation and/or deletion of p53, a cell cycle regulatory gene, is a promising biomarker for predicting the risk of neoplastic progression in Barrett’s esophagus (BE). Although overexpression of p53 by immunohistochemistry (IHC) is a useful surrogate for point mutations, complete absence of p53 ...

It is unknown whether the subtypes of microscopic colitis represent distinct nosologic entities or related presentations of the same disease. Our aim was to search for epidemiologic differences and similarities among its various histopathologic subtypes, such as lymphocytic, collagenous, and ...

The occurrence of hyperplastic polyps during colonoscopy is usually considered an incidental finding of little or no clinical significance. We pursued the hypothesis that diagnosis of hyperplastic polyps on index colonoscopy predicted the occurrence of adenomatous polyps on follow-up colonoscopy. ...

Gastroparesis is a condition characterized by gastric retention in the absence of physical obstruction. As part of an ongoing project aimed at determining the pathogenesis of reactive gastropathy, we hypothesized that patients with gastroparesis, in whom potentially noxious substances (e.g., ...

Colorectal cancer (CRC) occurring in the setting of Inflammatory Bowel Disease (IBD) is relatively uncommon. Compared to sporadic CRC, the molecular pathogenesis of IBD-associated CRC has some distinctive features, particularly the timing of acquisition of genetic changes during progression through ...

Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC). Traditionally, CD is thought to involve the entire gastrointestinal tract in a patchy manner. UC involves the colon in a diffuse and continuous manner. Upper gastrointestinal inflammation, relatively ...

We designed this study to use a large national pathology database to better characterize the demographic and clinicopathologic features of granular cell tumors (GCT) of the gastrointestinal tract. Because these tumors are relatively uncommon, their characteristics remain poorly defined. View the ...