Leslie B. Aldrich, MD and Scott R. Owens, MD, University of Michigan Health System, Ann Arbor, MI
The accurate diagnosis of inflammatory bowel disease (IBD) requires careful communication between clinicians and pathologists, knowledge of variant manifestations of disease, and attention to the effects of therapy on disease course. Without all of the "pieces of the puzzle" (and sometimes even with them), examining endoscopic biopsies from IBD patients can be a frustrating exercise.
This course provides a case-based overview of IBD with input from a practicing clinician (Dr. Aldrich) and a gastrointestinal pathologist (Dr. Owens), progressing from typical cases of ulcerative colitis and Crohn's disease through variants, mimics, and complications that often cause diagnostic confusion in the practice of general surgical pathology. Actual patients' cases are used, drawn from the clinical practice of Dr. Aldrich, with emphasis on the recognition by pathologists of common variants of IBD and the appropriate communication and conveyance of endoscopic and pathological findings between pathologists and clinicians. The course utilizes a "tag-team" approach, in which clinical and endoscopic information alternates with histopathological findings in the same patients. Each case is presented in a step-wise fashion, illustrating the evolution of the diagnostic and therapeutic aspects of the patient's disease, in concert with the tissue findings of all biopsies performed throughout the patient's continued care.
Still images with accompanying clinical histories will be posted on the USCAP website for review by pre-registrants before the meeting. A syllabus will be distributed at the meeting and course registrants will receive on-line access to the PowerPoint presentation after the Annual Meeting.
Upon completion of this educational activity, participants should be able to: 1) Describe the salient diagnostic features of ulcerative colitis and Crohn's disease, from both clinical and histological perspectives; 2) Recognize the clinical and histological features of variants and complications of inflammatory bowel disease, including the cecal patch, relative rectal sparing, upper tract involvement in ulcerative colitis, superimposed infectious complications, dysplasia, and indeterminate colitis; 3) Appreciate the synergistic relationship of clinicians and pathologists in the diagnosis and management of inflammatory bowel disease; and 4) Recognize and discuss the information and material that clinicians would ideally receive in pathology reports, and that pathologists would ideally receive in submitted clinical histories and tissue samples when caring for inflammatory bowel disease patients.