Gastrointestinal Pathology, An Issue of Surgical Pathology Clinics

This issue of Surgical Pathology Clinics, guest edited by Dr. Raul Gonzalez, will cover key topics in Gastrointestinal Pathology, including Grossing of Gastrointestinal Specimens, Subspecialty Signout, Diagnosis and Management of Gastrointestinal Neuroendocrine Neoplasms, and more.

\n Format: Hardback
\n Length: 240 pages
\n Publication date: 28 September 2020
\n Publisher: Elsevier - Health Sciences Division
\n

This issue of Surgical Pathology Clinics, guest edited by Dr. Raul Gonzalez, will cover key topics in Gastrointestinal Pathology. This issue is one of four selected each year by our series consulting editor, Dr. Jason L. Hornick. Topics discussed in this issue will include:

Grossing of Gastrointestinal Specimens: Best Practices and Current Controversies

Subspecialty Signout and Interobserver Variability in Gastrointestinal Pathology

Diagnosis and Management of Gastrointestinal Neuroendocrine Neoplasms

Daily Dilemmas in Pediatric Gastrointestinal Pathology

Upper Gastrointestinal Tract Manifestations of Inflammatory Bowel Disease

Gastric Polyps

Approaches to Biopsy and Resection Specimens of the Ampulla

Updates in Appendix Pathology

HER2 in Colorectal Carcinoma

Histology of Colorectal Carcinoma: Proven and Purported Prognostic Factors

Diagnoses and Difficulties in Mesenteric Pathology

Advances and Annoyances in Anus Pathology, among others.

The gastrointestinal tract is a complex organ system that plays a vital role in digestion, absorption, and metabolism. It is home to a diverse range of microorganisms, including bacteria, viruses, fungi, and parasites, that can cause a wide range of diseases and disorders. Gastrointestinal pathology is a field of medicine that focuses on the diagnosis and treatment of diseases and disorders that affect the gastrointestinal tract.

Grossing of Gastrointestinal Specimens: Best Practices and Current Controversies

Grossing of gastrointestinal specimens is a critical step in the diagnosis and management of gastrointestinal diseases. It involves the examination of tissue samples obtained during endoscopic procedures, such as colonoscopy, endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography (ERCP). The process of grossing involves the following steps:

Collection of the specimen: The specimen is collected by the endoscopist using a biopsy forceps or a brush. The specimen is then placed in a container and sent to the pathology laboratory for processing.

Fixation: The specimen is fixed in a solution of formaldehyde or other fixatives to preserve its structure and prevent further degradation.

Embedding: The specimen is embedded in a block of paraffin wax, which allows for sectioning and staining.

Sectioning: The embedded specimen is sectioned using a microtome, which produces thin slices of tissue that are stained with hematoxylin and eosin (H&E) to visualize the cellular and structural details of the tissue.

Staining: The stained sections are examined under a microscope by a pathologist to identify any abnormal findings.

Grossing of gastrointestinal specimens is a complex process that requires a high level of skill and expertise. There are several controversies surrounding the grossing of gastrointestinal specimens, including the use of different fixatives, the thickness of the sections, and the interpretation of the findings.

One of the most controversial issues in gastrointestinal grossing is the use of formaldehyde as a fixative. Formaldehyde is a highly toxic substance that can cause cancer and other health problems. However, it is also the most effective fixative for preserving tissue structure and preventing further degradation. There are concerns that the use of formaldehyde may increase the risk of cancer in patients who undergo gastrointestinal endoscopy.

Another controversial issue in gastrointestinal grossing is the thickness of the sections. The thickness of the sections can affect the accuracy of the diagnosis and the ability to identify abnormal findings. There are recommendations for the thickness of the sections based on the type of tissue being examined, but there is still some debate about the optimal thickness.

The interpretation of the findings is also a controversial issue in gastrointestinal grossing. Pathologists must interpret the findings of the grossing process in conjunction with other clinical information, such as the patient's history, physical examination, and laboratory tests. There is a risk of misinterpretation, which can lead to incorrect diagnoses and inappropriate treatment.

To address these controversies, there are ongoing efforts to improve the grossing of gastrointestinal specimens. One approach is the use of alternative fixatives, such as glutaraldehyde or paraformaldehyde, which are less toxic than formaldehyde. Another approach is the use of digital imaging technology, which can provide high-quality images of the sections and allow for more accurate interpretation of the findings.

Subspecialty Signout and Interobserver Variability in Gastrointestinal Pathology

Subspecialty signout and interobserver variability in gastrointestinal pathology are important issues that must be addressed to ensure accurate and reliable diagnosis and treatment of gastrointestinal diseases. Subspecialty signout refers to the process of assigning a pathology report to a specific subspecialty, such as gastrointestinal pathology or surgical pathology. This ensures that the report is reviewed by a pathologist with expertise in the specific area of pathology.

Interobserver variability refers to the difference in interpretation of pathology findings between different pathologists. This can occur due to differences in training, experience, and interpretation style. Interobserver variability can lead to incorrect diagnoses and inappropriate treatment.

To address these issues, there are several strategies that can be used. One strategy is the use of standardized protocols for grossing and interpreting gastrointestinal specimens. This ensures that all pathologists are following the same guidelines and that there is consistency in the diagnosis and treatment of gastrointestinal diseases.

Another strategy is the use of multidisciplinary teams, which include pathologists, gastroenterologists, and other healthcare professionals. This allows for a collaborative approach to the diagnosis and treatment of gastrointestinal diseases and ensures that all relevant information is considered.

There are also ongoing efforts to improve the training and education of pathologists in gastrointestinal pathology. This includes the development of training programs, workshops, and conferences that focus on the diagnosis and treatment of gastrointestinal diseases.

Diagnosis and Management of Gastrointestinal Neuroendocrine Neoplasms

Gastrointestinal neuroendocrine neoplasms (GNEs) are a group of tumors that arise from the cells of the gastrointestinal tract that produce hormones or neurotransmitters. GNEs can be benign or malignant and can affect any part of the gastrointestinal tract, from the stomach to the colon.

The diagnosis and management of GNEs are complex and require a multidisciplinary approach. The initial diagnosis of GNEs is typically made by endoscopy, which involves the use of a camera to examine the interior of the gastrointestinal tract. Endoscopy can be used to identify tumors, biopsy the tumor, and obtain tissue samples for histological examination.

Once the diagnosis of GNEs is made, the treatment options depend on the type and stage of the tumor. Benign GNEs can be managed with surgery, radiation therapy, or chemotherapy. Malignant GNEs can be managed with surgery, radiation therapy, chemotherapy, or targeted therapy.

Targeted therapy is a type of treatment that targets specific proteins or genes in the tumor cells. It is a highly effective treatment for GNEs that have specific mutations or proteins that are involved in the growth and progression of the tumor. Targeted therapy can be used alone or in combination with other treatments, such as surgery or radiation therapy.

Daily Dilemmas in Pediatric Gastrointestinal Pathology

Pediatric gastrointestinal pathology is a subspecialty of gastrointestinal pathology that focuses on the diagnosis and management of diseases and disorders that affect children. Pediatric gastrointestinal pathology is a complex and challenging field that requires a high level of expertise and experience.

There are several daily dilemmas that pediatric pathologists face in their practice. One of the most common dilemmas is the diagnosis of inflammatory bowel disease (IBD) in children. IBD is a chronic inflammatory disorder that affects the gastrointestinal tract, and it can be difficult to diagnose in children.

There are several diagnostic criteria for IBD in children, including the presence of chronic inflammation, the presence of ulcers or other abnormalities in the gastrointestinal tract, and the presence of antibodies associated with IBD. However, there is still some debate about the optimal diagnostic criteria for IBD in children.

Another daily dilemma in pediatric gastrointestinal pathology is the diagnosis of gastrointestinal tumors in children. Gastrointestinal tumors can be benign or malignant and can affect any part of the gastrointestinal tract. Pediatric gastrointestinal tumors can be difficult to diagnose due to their rarity and the lack of specific diagnostic criteria.

There are several diagnostic techniques that can be used to diagnose gastrointestinal tumors in children, including endoscopy, imaging studies, and biopsy. Endoscopy is the most commonly used diagnostic technique for gastrointestinal tumors in children, and it can be used to identify tumors, biopsy the tumor, and obtain tissue samples for histological examination.

Upper Gastrointestinal Tract Manifestations of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder that affects the gastrointestinal tract, including the stomach, intestines, and colon. IBD can manifest in a variety of ways, depending on the type and severity of the disease.

One of the most common manifestations of IBD is inflammation of the upper gastrointestinal tract, which can cause symptoms such as abdominal pain, diarrhea, and bleeding. Upper gastrointestinal tract manifestations of IBD can be difficult to diagnose and manage, as they can mimic other gastrointestinal disorders.

There are several diagnostic techniques that can be used to diagnose upper gastrointestinal tract manifestations of IBD, including endoscopy, imaging studies, and biopsy. Endoscopy is the most commonly used diagnostic technique for upper gastrointestinal tract manifestations of IBD, and it can be used to identify ulcers, inflammation, and other abnormalities in the gastrointestinal tract.

Gastric Polyps

Gastric polyps are growths that develop on the surface of the stomach. Gastric polyps can be benign or malignant and can affect any part of the stomach. Gastric polyps can be difficult to diagnose and manage, as they can mimic other gastrointestinal disorders.

There are several diagnostic techniques that can be used to diagnose gastric polyps, including endoscopy, imaging studies, and biopsy. Endoscopy is the most commonly used diagnostic technique for gastric polyps, and it can be used to identify polyps, biopsy the polyp, and obtain tissue samples for histological examination.

Approaches to Biopsy and Resection Specimens of the Ampulla

The ampulla of Vater is a small pouch that connects the duodenum to the common bile duct. The ampulla of Vater is a common site for the development of tumors, including adenocarcinomas and squamous cell carcinomas.

There are several approaches to biopsy and resection specimens of the ampulla of Vater, including endoscopic ultrasound-guided biopsy, endoscopic retrograde cholangiopancreatography (ERCP), and laparoscopic surgery. Endoscopic ultrasound-guided biopsy is the most commonly used approach for biopsying ampulla of Vater tumors, as it allows for high-quality images of the tumor and surrounding tissue.

Updates in Appendix Pathology

The appendix is a small pouch that attaches to the large intestine. The appendix is a common site for the development of tumors, including appendicitis and appendiceal carcinoma.

There are several updates in appendix pathology that have been made in recent years. One of the most significant updates is the recognition of the role of appendix inflammation in the development of appendicitis. Appendix inflammation is a common condition that can be caused by a variety of factors, including infection, inflammation, and trauma.

Another update in appendix pathology is the recognition of the role of appendix cancer in the development of appendicitis. Appendix cancer is a rare condition that can be difficult to diagnose and treat.

HER2 in Colorectal Carcinoma

Colorectal cancer is a type of cancer that affects the colon and rectum. Colorectal cancer is the second most common type of cancer in the United States and the third most common type of cancer in the world.

Colorectal cancer is a highly heterogeneous disease that can be classified into several subtypes, including adenocarcinoma, squamous cell carcinoma, and rectal cancer. HER2 is a protein that is overexpressed in certain types of colorectal cancer, including HER2-positive adenocarcinoma.

Histology of Colorectal Carcinoma: Proven and Purported Prognostic Factors

Histology of colorectal carcinoma is a critical component of the diagnosis and management of colorectal cancer. Histology involves the examination of tissue samples obtained during surgery or biopsy to identify the type and stage of the cancer.

There are several proven and purported prognostic factors that can be used to predict the outcome of colorectal cancer. One of the most important prognostic factors is the stage of the cancer. The stage of the cancer is determined by the size and location of the tumor and the extent of spread to surrounding tissues.

Another important prognostic factor is the grade of the cancer. The grade of the cancer is determined by the appearance of the tumor cells under a microscope. The grade of the cancer is important in determining the treatment options and the prognosis of the patient.

Diagnoses and Difficulties in Mesenteric Pathology

Mesenteric pathology is a subspecialty of gastrointestinal pathology that focuses on the diagnosis and management of diseases and disorders that affect the mesentery, which is a thin layer of tissue that connects the intestines to the abdominal wall. Mesenteric pathology is a complex and challenging field that requires a high level of expertise and experience.

There are several diagnoses and difficulties that mesenteric pathologists face in their practice. One of the most common diagnoses is mesenteric lymphadenitis, which is an inflammation of the lymph nodes in the mesentery. Mesenteric lymphadenitis can be caused by a variety of factors, including infection, inflammation, and trauma.

Another diagnosis that mesenteric pathologists face is mesenteric artery aneurysms, which are dilations of the arteries in the mesentery. Mesenteric artery aneurysms can be life-threatening and can cause symptoms such as abdominal pain, bleeding, and swelling.

Advances and Annoyances in Anus Pathology

Anus pathology is a subspecialty of gastrointestinal pathology that focuses on the diagnosis and management of diseases and disorders that affect the anus and rectum. Anus pathology is a complex and challenging field that requires a high level of expertise and experience.

There are several advances and annoyances that anus pathologists face in their practice. One of the most significant advances in anus pathology is the use of endoscopic ultrasound, which allows for high-quality images of the anus and rectum. Endoscopic ultrasound can be used to identify tumors, polyps, and other abnormalities in the anus and rectum.

Another advance in anus pathology is the use of virtual reality technology, which allows for the simulation of endoscopic procedures. Virtual reality technology can be used to train endoscopists and improve their skills and expertise.

In conclusion, gastrointestinal pathology is a complex and challenging field that requires a high level of expertise and experience. There are several key topics in gastrointestinal pathology that must be addressed to ensure accurate and reliable diagnosis and treatment of gastrointestinal diseases. These topics include grossing of gastrointestinal specimens, subspecialty signout and interobserver variability, diagnosis and management of gastrointestinal neuroendocrine neoplasms, daily dilemmas in pediatric gastrointestinal pathology, upper gastrointestinal tract manifestations of inflammatory bowel disease, gastric polyps, approaches to biopsy and resection specimens of the ampulla of Vater, updates in appendix pathology, HER2 in colorectal carcinoma, histology of colorectal carcinoma, proven and purported prognostic factors, diagnoses and difficulties in mesenteric pathology, and advances and annoyances in anus pathology. By addressing these key topics, we can improve the diagnosis and treatment of gastrointestinal diseases and ensure that patients receive the best possible care.

\n Weight: 606g\n
Dimension: 185 x 262 x 19 (mm)\n
ISBN-13: 9780323758802\n \n