Gastrointestinal Pathology

1 Cover

2 Title Page Gastrointestinal Pathology Correlative Endoscopic and Histologic Assessment Edited by Gregory Y. Lauwers, MD, FAGPS Senior Member and Director, Gastrointestinal Pathology Service Department of Pathology, Moffitt Cancer Center Professor, Departments of Pathology and Cell Biology and Oncologic Sciences University of South Florida Tampa, FL, USA Michael B. Wallace, MD, MPH Consultant – Gastroenterology and Hepatology Fred C. Andersen Professor of Medicine, Mayo Clinic School of Medicine Jacksonville, FL, USA Associate Editor: Till S. Clauditz, MD Associate Professor, Head of Gastrointestinal Pathology Service Department of Pathology with Section Molecular Pathology and Cytology University Medical Center Hamburg‐Eppendorf, Hamburg, Germany

3 Copyright Page

4 List of Contributors

5 1 General Principles of Biopsy Diagnosis of GI Disorders Endoscopic Equipment for Tissue Sampling Pinch Biopsy Forceps Endoscopic Snare Devices Endoscopic Brush Cytology Endoscopic Fine‐Needle Aspiration (FNA) Devices Tissue Processing in the Endoscopy Laboratory Non‐oriented Samples Oriented Samples Cytology Samples Culture Samples Specific Organ Sampling Methods Summary Further Reading

6 2 Esophagus Inflammatory Conditions Normal Histology, Variations Infectious Esophagitis Gastroesophageal Reflux Disease Eosinophilic Esophagitis Lymphocytic Esophagitis Drug‐Induced Esophagitis Sloughing Esophagitis Graft Versus Host Disease of the Esophagus Radiation Esophagitis Dermatological Diseases Involving the Esophagus Esophagitis and Inflammatory Bowel Disease Further Reading

7 3 Epithelial Metaplastic, Polypoid, and Neoplastic Conditions of the Esophagus Barrett’s Esophagus Barrett’s Esophagus–Dysplasia—Esophageal Adenocarcinoma Squamous Cell Dysplasia and Carcinoma Epithelial Polyps Heterotopias Glycogenic Acanthosis Mesenchymal Polyps Leiomyoma and Leiomyosarcoma Giant Fibrovascular Polyp Gastrointestinal Stromal Tumor (GIST) Hemangioma Kaposi Sarcoma Miscellaneous Tumors Esophageal Lymphoma Further Reading

8 4 Inflammatory Disorders of the Stomach Helicobacter‐Associated Gastritis and Peptic Ulcer Disease Acute (Erosive/Hemorrhagic) Gastritis Chemical (Reactive) Gastritis/Gastropathy Granulomatous Gastritis Gastritides with Prominent Lympho(plasma)cytic Infiltrate Infectious Gastritis Eosinophilic Gastritis Collagenous Gastritis Iatrogenic Gastritis Vascular Gastropathy Hypertrophic Gastropathy Further Reading

9 5 Polyps of the Stomach Fundic Gland Polyps (FGPs) Hyperplastic Polyps Gastric Adenoma Juvenile Polyps Peutz–Jeghers Syndrome Cowden's Disease Cronkhite–Canada Syndrome Gastric Adenocarcinoma and Proximal Polyposis of the Stomach (GAPPS) Nonepithelial and Malformative Polypoid Lesions Lipoma Xanthoma Gastric Heterotopic Pancreas Menetrier's Disease Further Reading

10 6 Gastric Neoplastic Conditions Dysplasia in Gastric Mucosa Early Gastric Cancer Adenocarcinoma of the Stomach Neuroendocrine Tumors Neuroendocrine Carcinoma Nonepithelial Tumors Further Reading Gastric Neoplastic Conditions Further Reading

11 7 Inflammatory and Miscellaneous Conditions of the Small Intestine Inflammatory Conditions Microvillus Inclusion Disease Intestinal Epithelial Dysplasia (Tufting Enteropathy) Acrodermatitis Enteropathica Infections Cryptosporidiosis Isospora Microsporidiosis Strongyloidiasis Mycobacterial Infection— Mycobacterium avium Intracellulare Complex (MAIC) and Mycobacterium tuberculosis Whipple's Disease Yersiniosis Adenovirus Cytomegalovirus Human Immunodeficiency Virus Celiac Disease Autoimmune Enteropathy Tropical Sprue Small Intestinal Bacterial Overgrowth Chronic Variable Immunodeficiency (CVID) Selective IgA Deficiency Graft Versus Host Disease Collagenous Sprue Refractory Celiac Disease (RCD) Crohn's Disease Food Protein‐Induced Enteropathy Eosinophilic Enteritis Histiocytic/Granulomatous Enteritis Necrotizing Enterocolitis (NEC) Intestinal Ischemia (Syn. Ischemic Enteritis) Radiation Enteritis Peptic Duodenitis NSAID Enteropathy Isolated Ileitis/Erosion Behcet's Disease Cryptogenic Multifocal Ulcerating and Stenosing Enteritis (CMUSE) Miscellaneous Disorders Deposition Disorders Amyloidosis Abetalipoproteinemia Further Reading

12 8 Polyps of the Small Intestine Heterotopia Hamartoma Endometriosis Pseudopolyp (Benign Mucosal Polyp, Inflammatory Pseudopolyp) Mucosal Prolapse Type Polyps Brunner's Gland Cyst Polyposis Syndromes PTEN Hamartoma Tumor Syndrome (Syn. Cowden Syndrome) Lymphoid Hyperplasia Pneumatosis Intestinalis Nonneoplastic Vascular Lesions Further Reading

13 9 Epithelial and Nonepithelial Neoplasms of the Small Intestine Adenoma Pyloric Gland Adenoma Intestinal Type Adenoma Serrated Polyps Carcinoma Adenocarcinoma of Pyloric Gland Type Neuroendocrine Neoplasms (Well‐Differentiated Neuroendocrine Tumors (NET), Neuroendocrine Carcinoma (NEC), Mixed endocrine‐non‐endocrine neoplasms (MiNEN)) Gangliocytic Paraganglioma Gastrointestinal Stromal Tumor (GIST) Inflammatory Fibroid Polyp Other Mesenchymal Tumors Lymphoma B‐Cell Non‐Hodgkin Lymphoma T‐Cell/NK‐T Cell Non‐Hodgkin Lymphoma Hodgkin Lymphoma Hematopoetic Disorders with Plasmacytic Differentiation Plasmablastic Lymphoma Lymphoplasmacytic Lymphoma Other Hematopoetic Disorders Leukemia Histiocytic Disorders Metastases to the Small Intestine Mucosa Further Reading

14 10 Inflammatory Conditions of the Colon Non‐Idiopathic Inflammatory Colitides Pseudomembranous Colitis and Antibiotic‐Associated Diarrhea and Colitis Brainerd Diarrhea Parasites Helminthic Infections Sexually Transmitted Infections Etiology of Colitis with Pattern Recognition Treatment/Prognosis/Evolution Radiation Proctocolitis Treatment/Prognosis/Evolution Neutropenic Enterocolitis (Typhlitis) Treatment /Prognosis / Evolution Variant Patterns of Collagenous Colitis have been Reported Findings in Other Segments of the Gastrointestinal Tract Colonic Diverticulosis and Diverticular Colitis Mucosal Prolapse/Solitary Rectal Ulcer Syndrome (MPSRUS) Pneumatosis Coli Treatment/Prognosis/Evolution Phlegmonous Colitis Obstructive Colitis Drug‐Associated and Iatrogenic Colitis Eosinophilic Conditions Affecting the Colon Mastocytic Enterocolitis Graft Versus Host Disease (GVHD) Further Reading Inflammatory Bowel DiseaseDefinition, General Features, Predisposing Factors Clinical and Endoscopical Features Microscopic Findings Morphologic Variants of UC and CD Crohn's Disease Differential Diagnosis Treatment/Prognosis/Evolution Further Reading Dysplasia in Inflammatory Bowel DiseaseDefinition, General Features, Predisposing Factors Clinical Features/Endoscopic Characteristics Microscopic Features Architectural Features Cytological Features Variant Patterns The Classification and Grading of Dysplasia Differential Diagnosis Role of Immunohistochemistry Treatment and Prognosis Further Reading

15 11 Polyps of the Large Intestine Epithelial Polyps Inflammatory Polyps Hamartomatous Polyps Mesenchymal Polyps Miscellaneous Polyps Further Reading

16 12 Epithelial Neoplasms of the Large Bowel Colorectal Carcinoma Malignant Colorectal Polyp Neuroendocrine Neoplasms Lymphomas of the Large Bowl Further Reading

17 13 Inflammatory Conditions of the Anus Anal Fissure Hemorrhoids Anal (Rectal) Tonsil Hidradenitis Suppurativa Anal Abscess and Fistula Inflammatory Bowel Disease Anorectal Tuberculosis Syphilis Clinical Features and Endoscopic Characteristics Lymphogranuloma Venereum Granuloma Inguinale Chancroid Herpes Simplex Virus Further Reading

18 14 Polyps and Neoplastic Lesions of the Anus Inflammatory Cloacogenic Polyp Fibroepithelial Polyp Hidradenoma Papilliferum Squamous Hyperplasia and “Leukoplakia” Condyloma Acuminatum Anal Intraepithelial Neoplasia (AIN)/Anal Squamous Intraepithelial Lesion (ASIL) Perianal Intraepithelial Neoplasia (PAIN), Bowen's Disease, and Bowenoid Papulosis Extramammary Paget's Disease Squamous Cell Carcinoma Verrucous Carcinoma (Giant Condyloma of Buschke and Löwenstein) Adenocarcinoma Malignant Melanoma Miscellaneous and Rare Tumors Further Reading