Ulcers are a common source of lower gastrointestinal bleeding caused by a wide variety of conditions. identifying the underlying etiology can be difficult in daily practice, particularly in limited biopsy tissue samples.
Increasing the accuracy of the diagnosis and turn-around time ultimately improves the quality of patient care, emphasize Yue Xue, MD, PhD, and Guang-Yu Yang, MD, PhD, who will present an education session, Diagnostic Challenges in Lower Gastrointestinal Tract Ulcers: Histopathological Approach for Appropriate Diagnosis in Biopsy Specimens, as part of the Surgical Pathology Track during the ASCP 2023 Annual Meeting on Oct. 19, at 8:30 a.m.
“There are many conditions that can cause ulcers. A pathologist’s job is to determine what kind of etiology it is, Is it an infection? Is it medication? Unfortunately, there is often significant histologic overlap among these conditions. It is hard for us to discern which caused it,” says Dr. Yang, who is vice chair of Anatomical Pathology, director of Gastrointestinal Pathology, and the Joseph C. Calandra Research Professor of Pathology and Toxicology at Northwestern Medicine.
Dr. Xue, who will become director of Gastrointstinal Pathology at Case Western Reserve University, adds, “Sometimes subtle different morphology may suggest different causes.”
Their case-based session will review the histology of lower gastrointestinal ulcers caused by different types of etiologies, together with the endoscopic impression and clinical history, to enable the pathologist to suggest a range of etiologies with a differential diagnosis, or in some cases, to suggest a specific diagnosis. This session will also address common scenarios in which a lower gastrointestinal tract ulcer is caused by idiopathic inflammatory bowel disease (IBD), discuss how to distinguish IBD-related ulcer from those caused by other etiologies and how to distinguish ulcers associated with epithelial reactive atypia from those associated with dysplasia, and review pre-analytic parameters that may affect pathologic interpretation.
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