The clinical significance of focally enhanced gastritis.
The clinical significance of focally enhanced gastritis.
The clinical significance of focally enhanced gastritis.
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<strong>The</strong> <strong>clinical</strong> <strong>significance</strong> <strong>of</strong> <strong>focally</strong><strong>enhanced</strong> <strong>gastritis</strong>.Xin W and Greenson JKDepartment <strong>of</strong> Pathology, University <strong>of</strong> Michigan,Ann Arbor, MI, USA.Am J Surg Pathol 28: 1347-1351 (2004)
Focally <strong>enhanced</strong> <strong>gastritis</strong>...• 927 patients, follow-up > 3.5 years• 34 cases with FEG• 4 <strong>of</strong> 34 patients had/developed IBD– 2 CD– 1 UC– 1 IC• 5 <strong>of</strong> 34 patients: status post bone marrowtransplantationXin and Greenson 2004
Histologic differences between children andadults presenting with ulcerative colitis.Tang LH, Reyes-Mugica M, Hao LDepartment <strong>of</strong> Internal Medicine, DanderydHospital, Danderyd, SwedenModern Pathology 14: 96A (2002)
Patterns <strong>of</strong> colonic involvement atinitial presentation in ulcerative colitis:a retrospective study <strong>of</strong> 46 newlydiagnosed cases.Robert ME, Skacel M, Ullman T, Bernstein CN, EasleyK, Goldblum JR.Department <strong>of</strong> Pathology, Yale University School <strong>of</strong>Medicine, New Haven, CT 06520-8023, USA.Am J Clin Pathol 122: 94-9 (2004)
Rectal sparing <strong>of</strong> UC...• Effect <strong>of</strong> therapy (40%, steroids)• Burn-out <strong>of</strong> long standing disease• Relative rectal sparing (up to 30%)• Absolute rectal sparing (1-2%)• In pediatric patients (3-4%)Robert et al. 2004
Indeterminate Colitis...• In Biopsy series in 13-20%• Representative material• Precise information• Inclusion <strong>of</strong> all <strong>clinical</strong> und radiologydata• No small bowel lesionsInternat Surg 1994, Current Diagnostic Pathology 1996
Train track ulcers, cobble-stones
Stricture
NSAIDS-Dicl<strong>of</strong>enac
Focally <strong>enhanced</strong> <strong>gastritis</strong>: a frequenttype <strong>of</strong> <strong>gastritis</strong> in patients with Crohn´sdisease.Oberhuber G, Puspöck A, Oesterreicher C,Novacek G, Zauner C, Burghuber M, Vogelsang H,Potzi R, Stolte M, Wrba F.Department <strong>of</strong> Pathology, University <strong>of</strong> ViennaMedical School, Austria.Gastroenterology 112: 698-706 (1997)
20 centres in North- und South-Europe2200 patients mit IBDIndeterminate Colitis % (range)NORTHSOUTHPathology 16 (10-36) 8 (0-20)Pathology+ClinicsFollow-up(2 years)9 (3-17) 2 (0-10)5 (1-7) 1 (0-4)Shivananda et al. Current Diagnostic Pathology 1996
Change <strong>of</strong> diagnosis...• Almost always from CU >> CD!• Clinical bias!• <strong>The</strong>rapy (Steroids)• Cecitis, Inflammatory polyps• Dissoziation <strong>of</strong> inflammation• Co-existence <strong>of</strong> UC and CD?
Normal Endoscopy...• Collagenous Colitis• Lymphocytic Colitis• Isolated Granulomata• Amyloidosis• Intestinal Spirochetosis• Cryptosporidia• Normal Colon – Do not be dissapointet
Absorp. CellsPaneth CellsGoblet CellsMonon. CellsEosinophilsIELApoptosis
Geographic variations in eosinophil concentrationin normal colonic mucosa.Pascal RR, Gramlich TL, Parker KM, Gansler TS.Department <strong>of</strong> Pathology, Emory University School <strong>of</strong> Medicine, Atlanta,Georgia, USA.Mod Pathol 10:363-365 (1997)
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