By Elizabeth A. Montgomery MD, Lysandra Voltaggio MD
Gastrointestinal mucosal biopsies are an lively a part of the pathologist’s day and feature elevated some time past few years as endoscopic screening has turn into extra common. This new full-color moment variation of Biopsy Interpretation of the Gastrointestinal Tract Mucosa has been accelerated into concise, finished volumes to provide extra entire insurance of either non-neoplastic and neoplastic entities. just like the different books within the Biopsy Interpretation Series, those volumes are useful references for pathologists to take advantage of while making diagnostic judgements according to biopsy specimens.
Volume 2 of this moment version specializes in interpretation of neoplastic gastrointestinal mucosal biopsies. assurance is geared to day-by-day perform and comprises mucosal biopsies from the esophagus, belly, small gut, huge gut, and anus. A significant other site will contain all the three hundred print illustrations plus an extra 750 e-figures.
Volume 1 makes a speciality of non-neoplastic biopsies and released in November 2011.
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Additional info for Biopsy Interpretation of the Gastrointestinal Tract Mucosa: Volume 2: Neoplastic
They are characterized by uniform bland tumor cells with an insular pattern and solid to cribriform growth. They express keratin, synaptophysin, and chromogranin. They can be associated with heterotopic oxyntic mucosa. 52 Well-differentiated neuroendocrine (carcinoid) tumor. This tumor of the esophagus shows the same microscopic features as those in other sites with nests of bland, small, neuroendocrine cells located within the lamina propria. These tumors are very rare in this location. Like such tumors elsewhere, they can be graded by assessing the mitotic activity (to the extent possible in small biopsies) or by performing Ki-67 immunolabeling (92): G1 <2 mitoses per 10 high-power fields or <2% Ki-67 index G2 mitotic count 2 to 20 per 10 high-power fields or 3% to 20% Ki-67 index.
Express p63, CK5/6, and the host of epithelial markers. Most examples are not a diagnostic problem. When spindled, melanoma and sarcomas must be excluded. The best way to do this is by sampling as much of the overlying squamous mucosa as possible to detect an in situ component. 46 Sarcomatoid squamous cell carcinoma. Note the atypical mitoses. (Courtesy of Dr. 47 Verrucous carcinoma. Even at this magnification, the features are bland and the clue to diagnosis is the hypergranulosis (the esophagus lacks a granular cell layer), and broad pushing papillae.
Observer reproducibility in recognizing BCD is similar to that for low-grade dysplasia (45). Other cases of high-grade dysplasia have a subtle, “nonadenomatous” or “small cell pattern” that consists of numerous, tiny glands that appear bland at low magnification, but that display nuclear alterations at high magnification (Fig. 33, e-Figs. 140). Occasionally, dysplasia extends laterally on the surface of nonneoplastic cardiac or cadiac–oxyntic glands (Fig. 34, e-Figs. 146). Additionally, patients who have had colonic interpositions (in which a segment of colon is used to reconstruct the esophagus after an esophagectomy) can still acquire Barrett-associated neoplasia in their residual esophagus (e-Figs.