A 74 yo male presented with right lower quadrant tenderness. He denied nausea, vomiting, fevers, and abnormal bowel movements. CT scan revealed a 6 cm mass centered in the right colon. Colonoscopy was unremarkable, and the patient underwent surgical resection.
Dear GIPS Members –
GIPS will be delivering up to date education content on biomarkers at the ASCP Annual Meeting via a virtual lecture series. Please see below for more information on this upcoming session.
DMT517-21 Presented by GIPS:
Updates on Biomarker Testing in Gastrointestinal Malignancies
Jinru Shia, MD
Andrew Bellizzi, MD FASCP
12:30 PM – 1:30 PM EDT on Sunday, October 17
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Funded by an independent educational grant from Merck Sharp and Dohme Corp.
The recent years have seen the emergence of many highly specific immunohistochemistry biomarkers directed against the protein products of specific genetic alterations in gastrointestinal malignancies. Such markers have improved tumor prognostication and, most importantly, served to direct effective targeted therapies. The effectiveness of tumor biomarkers, however, hinges on optimal testing methodology and accurate interpretation of the testing results. Standardization is therefore key. As the targeted therapies are most utilized in advanced and unresectable malignancies, the available test samples are often small biopsies and not infrequently cytology materials, which calls for further attention in test optimization and standardization. The aim of this session is to provide an update on the testing of tumor biomarkers in GI malignancies, with an emphasis on HER2 testing in colorectal carcinoma, and the unique aspects of utilizing minimal material including cytology material as test samples.
- To gain an overview of the newly emerged and emerging prognostic and predicative biomarkers in gastrointestinal malignancies.
- To achieve an improved understanding of HER2 testing in colorectal cancer, and be able to address the frequently encountered questions relate to this test.
- To know the pitfalls and caveats in biomarker testing with minimal tissue samples including cytology materials.
A 33-year-old female with history of gastroesophageal reflux disease and H. pylori gastritis presented with epigastric pain and dysphagia. Endoscopic ultrasound demonstrated a 2.5 cm mass located on the lesser curvature and originating from within the muscularis propria.
A 19-year-old woman presented to her gastroenterologist with a chief complaint of chronic abdominal pain. Her past medical history included allergic rhinitis, anxiety, gastroesophageal reflux disease, iron deficiency anemia, migraines, and an eating disorder. Her medications included amitriptyline, gabapentin, acetaminophen, esomeprazole magnesium, ferrous sulfate, fluticasone propionate nasal spray, hyoscyamine, melatonin, and omeprazole. Laboratory tests for tissue transglutaminase IgA and deaminated gliadin were negative. Serum IgA levels were normal. She underwent esophagogastroduodenoscopy which showed a normal-appearing esophagus, bilious-appearing fluid in the stomach, moderate erythema of the gastric antrum and body with significant nodularity of the gastric body, and a normal appearing duodenum. Biopsies were obtained of the esophagus, gastric antrum and body, and duodenum. The biopsies of the esophagus, antrum, and duodenum were normal. Endoscopic photos of the gastric body and photomicrographs of the H&E-stained slides of the gastric body are seen below. Immunohistochemical stains for gastrin and H. pylori and Congo red stain for amyloid on the biopsies of the gastric body were negative. Prior biopsies of her colon were normal.
A 77-year-old man taking the proton pump inhibitor (PPI) pantoprazole for several years to treat gastroesophageal reflux underwent an upper endoscopy during which a polyp in the gastric body was identified.
June 2021_Case of the month_GIPS-edited
Link to course: https://www.xcdsystem.com/uscap/program/73kUdpa/index.cfm?pgid=3578
The Old and The New:
A Comprehensive Approach to the GI Tract
OCTOBER 5-8, 2021
Available Credits 24.5 CME
USCAP Member Price $899, Non-Member Price $1,199, Pathologist-in-Training $699
Drs. Gregory Y. Lauwers, Amitabh Srivastava, Dora Lam-Himlin, Nicole C. Panarelli, Lysandra Voltaggio, and Christina A. Arnold
This comprehensive approach to the gastrointestinal system is designed to educate general pathologists, junior GI pathologists and pathologists-in-training on problematic areas of common and unusual lesions, the newest guidelines and how they impact the diagnostic process, and practical approaches and tips to avoid diagnostic pitfalls. The structure of this course, divided along the GI anatomic landscape, allows the faculty to emphasize key diagnostic features of inflammatory, infectious and neoplastic pathology as encountered in biopsy and resection specimens. The cases are selected to assist in developing an appropriate differential with emphasis on how to navigate to the correct diagnosis. Supplementary cases and special studies will augment the discussion to present the full morphologic spectrum and show how to incorporate ancillary studies effectively. At the conclusion of the course, participants will be able to develop and work through the differential diagnostic possibilities and render the best possible diagnosis. This is USCAP mentoring at its best!
- Correctly classify dysplasia in Barrett esophagus, stomach and anus
- Distinguish medication, infection and systemic disease involvement of the GI tract
- Formulate a differential diagnosis for sprue-like lesions of the small bowel
- Comprehend the proper classification of gastric and colonic polyps and mucinous appendiceal lesions
- Evaluate the key features of colorectal staging
61 year old female presents to GI clinic with history of non-bloody, watery diarrhea that waxed and waned for years, but was more consistent in the past 4 months.
Congratulations to Dr. Anirban Maitra, recipient of the 2021 Jack Yardley Investigator Award!
Congratulations to Dr. Thomas Smyrk, recipient of the 2021 Harvey Goldman Lifetime Achievement Award!