Difference between revisions of "An introduction to gastrointestinal pathology"

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An introduction to gastrointestinal pathology (view source)

Revision as of 16:06, 17 January 2011

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split-out GVHD
(+GVHD)
(split-out GVHD)
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An organ that is occasionally afflicted by cancer.  It is primarily seen in large centers where they do ERCPs and Whipples.
An organ that is occasionally afflicted by cancer.  It is primarily seen in large centers where they do ERCPs and Whipples.


=Pathology=
=Pathology (detail articles)=
==Graft-versus-host disease==
==Inflammatory bowel disease==
*Abbreviated as ''GVHD''.
{{Main|Inflammatory bowel disease}}
===General===
The bread and butter of gastroenterology and GI pathology.
*Complication of hematopoietic stem cell transplantation, i.e. bone marrow transplantation (BMT).
*Histology of GVHD the same rejection in bowel transplantation.<ref>GT. 14 January 2011.</ref>


Clinical:
==Gastrointestinal stromal tumour==
*May present as diarrhea.
{{Main|Gastrointestinal stromal tumour}}
*Main DDx (clinical): infection.
The most common GI stromal tumour.


===Microscopic===
==Graft-versus-host disease==
Features:<ref name=pmid20953169>{{cite journal |author=Cogbill CH, Drobyski WR, Komorowski RA |title=Gastrointestinal pathology of autologous graft-versus-host disease following hematopoietic stem cell transplantation: a clinicopathological study of 17 cases |journal=Mod. Pathol. |volume=24 |issue=1 |pages=117–25 |year=2011 |month=January |pmid=20953169 |doi=10.1038/modpathol.2010.163 |url=http://www.nature.com/modpathol/journal/v24/n1/full/modpathol2010163a.htm}}</ref>
{{Main|Graft-versus-host disease}}
*Isolated epithelial cell apoptosis - '''key feature'''.
An uncommon thing that complicates bone marrow transplants.
*+/-Crypt destruction (focal or extensive).
*+/-Loss of epithelium (denudation).
 
Notes:
*Neutrophils should not be present.
 
Images:
*[http://www.nature.com/modpathol/journal/v24/n1/fig_tab/modpathol2010163f1.html#figure-title GVHD grade 1-4 (nature.com)].
 
====Grading<ref name=pmid20953169/>====
*Grade 1 = isolated epithelial cell apoptosis.
**No crypt loss/destruction.
*Grade 2 = individual crypts are lost/scatter destruction of single crypts.
*Grade 3 = foci several adjacent crypts lost.
*Grade 4 = large number of adjacent crypts lost/loss of epithelium.
 
Notes:
*Low-grade rejection is a diagnosis that requires a careful examination, i.e. it is subtle.


=See also=
=See also=
Michael
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