Potential pitfalls in reporting non-neoplastic gastrointestinal mucosal biopsies.

Biopsies taken from the gastrointestinal tract (GIT) comprise a significant percentage of the pathologists' routine work. The variable histology and normal components of each organ along the GIT, as well as the different ways of responding to injury among these organs, can cause morphological changes that could result in potential diagnostic pitfalls. Herein, we review the pathological conditions of the GIT that could cause these diagnostic pitfalls.

Pitfalls in the reporting of neoplastic and pseudo neoplastic lesions in the colon and rectum.

Colonic biopsies comprise large portion of pathologists' daily work. Within various pathological entities, there are histological ranges and variations. Unawareness of all of these variabilities might lead to misdiagnosis by an inexperienced pathologist and, accordingly, to mismanagement.

Portal hypertension in primary biliary cholangitis: prevalence, natural history and histological correlates.

Objectives: The histopathological mechanisms underlying portal hypertension in primary biliary cholangitis (PBC) are poorly understood, as is its natural history. We have therefore determined the prevalence, severity and progression of portal hypertension in PBC and investigated whether its presence is related to specific histological lesions.

Methods: Hepatic venous pressure gradient (HVPG) was measured in 86 patients, with 186 assessments over up to 7 years of follow-up and the results correlated with a semiquantitative grading of 8 histological features and nodular regenerative hyperplasia (NRH).

The effect of radiotherapy on rectal cancer: a histopathological appraisal and prognostic indicators.

The management of rectal cancer is a major undertaking. There are currently multiple treatment modalities with variable degrees of complications. Radiotherapy (RT) is one of the more frequently used modalities either on its own or more frequently with chemotherapy mostly before the definitive surgery.

The risk of lymph node metastasis in T1 colorectal cancer: new parameters to assess the degree of submucosal invasion.

Purpose: In T1 colorectal cancer, the depth is the main factor assessing the degree of submucosal invasion (DSI) to predict the risk of lymph node metastasis (LNM). The width (WSI) and the area of submucosal invasion (ASI) have been suggested as additional parameters to assess the risk of LNM. A review of the literature was undertaken on the correlation between WSI and ASI parameters and the incidence of LNM.

Histopathological Mimics of Inflammatory Bowel Disease.

This review article discusses the challenges of making a firm histopathological diagnosis of inflammatory bowel disease (IBD) on biopsy and resection material and the importance of its distinction from a range of other inflammatory and infective conditions that may closely mimic IBD. In many cases, the diagnosis of ulcerative colitis or Crohn's disease is straightforward, especially when patients have a typical presentation and characteristic histopathological features. Knowledge of the full clinical history is very important, particularly past and recent medical history, drug history, foreign travel, or known contact with individuals with specific infection.

Liver biopsy in primary biliary cholangitis: is sinusoidal fibrosis the missing key?

Aims: The role of liver biopsy in primary biliary cholangitis (PBC) is controversial, as is the optimal method of histological assessment. We compared the Ludwig and Ishak systems and three components of the Japanese (Nakanuma) staging system to evaluate their clinical and biochemical correlations and prognostic value.

Methods: We reviewed biopsies from 106 patients with PBC, derived from a previous trial of colchicine therapy with 24-34 years' follow-up, following which five clinical outcomes were evaluated: hepatic decompensation, cholestatic PBC death/liver transplant, portal hypertensive PBC death, all PBC deaths and overall survival.

Reporting Colonic Biopsies in Patients With Inflammatory Bowel Disease; a Practical Approach.

Crohn's disease (CD) and ulcerative colitis (UC) are common diseases; for convenience, we lump them together as inflammatory bowel disease (IBD). Colonic biopsies are essential for establishing a diagnosis, monitoring treatment, and/or identifying complications. This article attempts to detail the histological criteria of UC and CD and also informs on a lifelong approach of reporting colonic biopsies from patients with IBD.

Pelvic radiation therapy: Between delight and disaster.

In the last few decades radiotherapy was established as one of the best and most widely used treatment modalities for certain tumours. Unfortunately that came with a price. As more people with cancer survive longer an ever increasing number of patients are living with the complications of radiotherapy and have become, in certain cases, difficult to manage.

Lymph node harvest in colon and rectal cancer: Current considerations.

The prognostic significance of identifying lymph node (LN) metastases following surgical resection for colon and rectal cancer is well recognized and is reflected in accurate staging of the disease. An established body of evidence exists, demonstrating an association between a higher total LN count and improved survival, particularly for node negative colon cancer. In node positive disease, however, the lymph node ratios may represent a better prognostic indicator, although the impact of this on clinical treatment has yet to be universally established.