SHORT COURSE

Wednesday Afternoon - February 15, 1:30 PM - 5:30 PM




08. Mimics in Gastrointestinal Pathology

Alyssa M. Krasinskas, M.D., University of Pittsburgh Medical Center, Pittsburgh, PA, Jeffrey D. Goldsmith, M.D., Beth Israel Deaconess Medical Center, Boston, MA, and Susan C. Abraham, M.D., Mayo Clinic, Rochester, MN.

Non-neoplastic pathologic processes in the gastrointestinal tract can mimic malignancy or other non-neoplastic gastrointestinal diseases. When only a small mucosal biopsy is available for review, distinguishing reactive lesions from neoplasia or one inflammatory disease from another can often be extremely challenging. This course will use a case-based format to present examples of endoscopic biopsies that illustrate mimics in gastrointestinal pathology. These cases will represent pathologic processes that are seen in everyday practice and will include mimics of gastric, ampullary and colonic neoplasia, as well as mimics of significant inflammatory conditions such as inflammatory bowel disease and celiac disease. Some examples include peptic duodenitis mimicking celiac disease, distinction of mucosal prolapse changes from dysplasia and inflammatory bowel disease, reactive changes at the ampulla mimicking ampullary adenoma or adenocarcinoma, pseudoinvasion versus adenocarcinoma in colonic adenomas, and diverticular disease-associated segmental colitis mimicking Crohn’s disease. Upon completion of the course, participants should be able to recognize subtle features in endoscopic gastrointestinal biopsies that allow them to distinguish reactive from neoplastic processes and some common inflammatory conditions from other more obscure ones. Participants should also learn about the limitations of biopsy pathology and recognize instances when a differential diagnosis should be rendered, rather than a definitive diagnosis.

This course is intended for both practicing surgical pathologists and pathologists in training. Case histories and slides in CD-ROM format will be available for advance mailing. A comprehensive syllabus will be distributed at the course.