Blog Posts in December 2014
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The Endoscopically Normal Stomach: Is It Worth a Biopsy?
In the absence of endoscopically visible lesions (such as tumors or ulcers), the gross appearance of the gastric mucosa is not believed by some gastroenterologists to be a reliable predictor of histopathologic findings. This is because in their experience, biopsies obtained from endoscopically ...
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Helicobacter pylori Gastritis: Atypical Infections May Be Missed Without the Regular Use of Special Stains
In most patients, Helicobacter pylori infection causes chronic active gastritis, a pattern that prompts pathologists to search for organisms, including the use of special or immunohistochemical stains. As a consequence of widespread use of antibiotics and proton pump inhibitors (PPIs), fewer gastric ...
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Low Prevalence of Villous Atrophy (Marsh 3) in Duodenal Biopsies from Americans of East Asian and Hispanic Ancestry and High Prevalence in Northern Indians
East Asian countries have historically reported low prevalences of celiac disease (CD). Data from Latin America are more varied, but rates similar to those found in Europe and the United States (US) are often cited. The prevalence of CD in India appears to vary by region, with Northern regions ...
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Pathogenetic Differences in the Progression of MLH1 Intact and Deficient Sessile Serrated Adenomas
Sessile serrated adenomas/polyps (SSA) are members of the serrated polyp family, often right sided, and are characterized by wide-bottomed crypts, disordered maturation, and dystrophic goblet cells histologically (Figure 1). SSAs frequently progress to cancer via MLH1 methylation silencing and the ...
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Subepithelial Fibrosis is a Distinctive Characteristic of Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is a chronic, allergy-related disease in which prolonged eosinophil-predominant inflammation can cause tissue remodeling. The remodeling results in serious complications including esophageal rings, strictures, and mucosal fragility, which can cause dysphagia, food ...
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Intestinal Metaplasia of the Inlet Patch: Clinical and Pathological Associations
Heterotopic gastric mucosa (HGM) located in the proximal esophagus is referred to as “inlet patch.” Although its prevalence is reported to be around 4%, the inlet patch is infrequently biopsied. Therefore, studies of its demographic and clinical associations have relied on small numbers ...
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Granulomas in Crohn's Disease are Associated With More Severe Disease Expression
The relevance of granulomas in the histopathology of patients with Crohn’s disease is largely unknown. Most previous studies have relied on small case series. The aim of our study was to test the influence of demographic and clinical characteristics in patients with Crohn’s disease on ...
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Ethnic Distribution of Microscopic Colitis
Variations in the occurrence of microscopic colitis among different ethnic groups may provide insights into its etiology. The aim of our study was to utilize a large electronic database of histopathology reports for the analysis of microscopic colitis variation among different ethnic groups within ...
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The Yield of Colonic Biopsy in the Evaluation of Chronic Unexplained Diarrhea
Diarrhea is a common symptom of patients with infectious, inflammatory and systemic diseases presenting with gastrointestinal manifestations. Colonoscopy with biopsy is widely used for the evaluation of diarrhea (often defined as “persistent diarrhea of indeterminate origin”). Biopsy ...
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Incidence and Clinicopathological Characteristics of Gleason Pattern 5 Prostate Cancer in Contemporary Needle Biopsies Series: A Prospective Study
Management of patients with prostate adenocarcinoma (PCa) heavily depends on the Gleason score assigned on prostate needle biopsy (NBX). The presence of a Gleason pattern 5 (GP5) PCa is associated with disease progression and the worst clinical outcome. Patients with GP5 are often not amenable to ...
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Low Prevalence of Microscopic Colitis and Inflammatory Bowel Disease in Americans of East Asian Ancestry
East Asian countries have historically reported low incidences of microscopic colitis and inflammatory bowel disease (1); however, it is unclear whether these data reflect genetic or environmental factors or are the result of different diagnostic criteria among physicians and pathologists. This ...
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Low Prevalence of Eosinophilic Esophagitis in Hispanics and Asians in the United States
National differences in the prevalence of eosinophilic esophagitis (EoE) have been described, but it is not clear whether these differences are real (due to differences in genetic or environmental factors) or spurious (due to national differences in awareness of the condition among physicians and in ...
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Barrett's Esophagus is Not Rare in Asian Patients Who Have Esophageal Biopsies Taken in the United States
National differences in the prevalence of Barrett’s esophagus (BE) have been described, but it is not clear whether these differences are real (due to differences in genetic or environmental factors) or spurious (due to national differences in endoscopic landmarks used by physicians to ...
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Influence of Patients' Ethnicity on the Gastric Biopsy Sampling Patterns
Although the Sydney System protocol requires separate biopsy sampling from antrum, incisura, and corpus, less than 4% of U.S. endoscopists adhere to these recommendations. There are significant differences in the prevalence of H. pylori and gastric preneoplastic lesions amongst the major ethnic ...
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High Prevalence of Ulcerative Colitis in US Residents of Indian Origin
The prevalence of Inflammatory bowel disease (IBD), including both Crohn Disease (CD) and ulcerative colitis (UC) is reportedly high in Ashkenazi Jews, but it is believed to be very low in the population from South and East Asia. Several reports summarized in a 2010 consensus meeting of the Indian ...
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The Prevalence of Gastric Preneoplastic Lesions in East Asians and Hispanics in the United States Parallels the Incidence of Gastric Cancer in Their Corresponding Ancestral Countries
The epidemiology of H. pylori infection and the incidence of gastric cancer (GC) and its precursor lesions in different countries are well established. However, the consequences of such variability for the healthcare of the multiethnic population of the US are less clear and have not been ...
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Ethnic Distribution of Atrophic Autoimmune Gastritis in the United States
Autoimmune Atrophic Gastritis (AIG) has classically been associated with “elderly women of Northern European ancestry.” (Friedlander, Am. J. Med. Sci, 1934) Several epidemiologic studies have shown equal prevalence in various ethnic groups in the US. (Carmel et al, N. Engl. J. Med. 1978; ...
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Gastric Antral Vascular Ectasia: The Invaluable Role of the Gastric Biopsy in its Detection and Confirmation
Gastric vasculopathies consist predominantly of two entities: Gastric antral vascular ectasia (GAVE) Portal hypertensive gastropathy (PHG) The classically described GAVE patient is an elderly woman with iron-deficiency anemia and a “watermelon” appearance of the gastric mucosa on ...
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Gastric Polyps: Shifting Paradigms in the Twilight of Helicobacter
H. pylori infection is declining in the industrialized world and emerging economies. Simultaneously, as the world population moves to a “Western” diet, obesity and gastroesophageal reflux disease are on the rise, and the use of acid-suppressing drugs, particularly proton pump inhibitors ...
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Correlation of P16 Expression and Clinicopathologic Outcome of Anal Squamous Cell Carcinoma
Anal squamous cell carcinoma (ASCC) is uncommon, and accounts for 4% of carcinomas involving the gastrointestinal tract. The pathogenesis of ASCC is still unknown. Many studies have shown a strong association of anal squamous cell carcinoma with human papilloma virus (HPV). In multiple studies, over ...
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Submucosal Lipoma and Sessile Serrated Adenoma/Polyp, More Than Just a Coincidence?
In our practice we noticed that sessile serrated adenomas/polyps (SSA/P) were frequently associated with submucosal lipomas (SL). While this finding has been reported by other experts, it is unclear if this phenomenon represents anecdotal association between SSA/P and SL or a distinct form of an ...
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Isolated Eosinophilic Colitis: A Challenging Diagnosis in Search of Criteria
Eosinophils infiltrate the colonic mucosa in response to tissue-invading parasites, as part of eosinophilic gastroenteritis (EoG), or as an isolated presumably allergic phenomenon. Focal infiltrates around parasite fragments are easily recognized and the simultaneous involvement of stomach or small ...
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Gastric Antral Vascular Ectasia: Relevance of the Histopathologic Diagnosis
Gastric Antral Vascular Ectasia (GAVE) is traditionally considered an endoscopic diagnosis. Because the role of the gastric biopsy is uncertain, and the relatively obscure criteria proposed by Gilliam ( Dig Dis Sci 1989; 34:885) are rarely used by practicing pathologists, gastroenterologists often ...
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Duodenal Adenomas Coincide with Colorectal Neoplasia
Published by Digestive Diseases and Sciences, April 6, 2014 Robert M. Genta, MD, Jennifer M. Hurrell, DO, Amnon Sonnenberg, MD, MSc Small case series have alluded to an association between sporadic duodenal adenomas and colorectal neoplasia. The strength of the association remains uncertain. This ...
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Heterogeneity of PTEN and ERG Biomarkers Expression in Prostate Cancer Needle Biopsies with More Than One Core Positive: Implications for Biomarkers Sampling Strategy
Both PTEN and ERG biomarkers demonstrate significant inter- and intra-tumor core staining heterogeneity, suggesting that sampling may affect biomarkers interpretation. View the poster
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