Citations 2
Non‐conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrum
Pereira, Daniela , Kővári, Bence , Brown, Ian , Choi, Won‐Tak , Ghayouri, Masoumeh, Miller, Gregory , Nakanishi, Yukihiro , Kim, Kyoung M., Kim, Baek H, Kumarasinghe, M. Priyanthi , Kushima, Ryoji , Ushiku, Tetsuo , Yozu, Masato , Goldblum, John R. , Pai, Rish K. , Lauwers, Gregory Y. , Choi, Won-Tak , Miller, Gregory C , Nakanishi, Yukihiro , Ushiku, Tetsuo , Lauwers, Gregory Y , Brown, Ian S , Chaves, Paula P. , Clauditz, Till Sebastian , Jiang, Kun , Srivastava, Amitabh
Histopathology | October 30, 2020 | Volume: 78 | Issue: 5 | Pages: 658-675
The increasing use of gastrointestinal endoscopic procedures has led to the recognition by histopathologists of non‐conventional (or special‐type) dysplasias of the gastrointestinal tract. These lesions can be recognised in association with prevalent underlying gastrointestinal conditions, such as Barrett oesophagus, chronic atrophic gastritis, and inflammatory bowel disease. The diagnosis of these special types can be challenging, and their biological behaviours are not fully characterised. The aim of this review is to provide a global view of non‐conventional dysplastic lesions observed in the various segments of the tubular gastrointestinal tract and describe their salient features. Furthermore, as the clinical implications of these various subtypes have not been broadly tested in practice and are not represented in most management guidelines, we offer guidance on the best management practices for these lesions.
Gastric pyloric gland adenoma: a multicentre clinicopathological study of 67 cases
Choi, Won‐Tak , Brown, Ian , Ushiku, Tetsuo , Yozu, Masato , Setia, Namrata , Srivastava, Amitabh , Johncilla, Melanie , Pai, Rish K. , Fukayama, Masashi , Misdraji, Joseph , Lauwers, Gregory Y. , Brown, Ian S , Gill, Ryan M. , Srivastava, Amitabh
Histopathology | December 26, 2017 | Volume: 72 | Issue: 6 | Pages: 1007-1014
AimsThere is limited information regarding the clinicopathological and immunohistochemical characteristics of gastric pyloric gland adenomas (PGAs).Methods and resultsSixty‐seven cases of gastric PGA from 57 patients were analysed. PGAs occurred with similar frequency in men and women (47.4 and 52.6%, respectively), with a mean age of 66 years. Most presented in the gastric body/fundus (67.2%). Fifteen cases (22.4%) developed against a background of autoimmune gastritis (AIG), whereas normal mucosa was seen in 35.8%. Only 16.4% (11 cases) developed in patients with a genetic predisposition, most commonly familial adenomatous polyposis. Low‐grade lesions had a mean size of 1.5 cm, while PGAs with high‐grade dysplasia (HGD) or adenocarcinoma had a mean size of 3.5 cm (P < 0.001) and more commonly showed tubulovillous architecture (50.0 versus 25.6% in low‐grade dysplasia; P = 0.040). Most PGAs (61.2%) co‐expressed mucin (MUC)5AC and MUC6 (mixed type), which was associated significantly with HGD or adenocarcinoma (P = 0.013). AIG was also associated with HGD (P = 0.027), but genetic predisposition did not correlate with the grade of dysplasia (P = 0.793). The recurrence rate of PGA was similar for high‐ (11.8%) and low‐grade lesions (7.4%) (P = 0.624).ConclusionsThe risk of HGD increases with the size of PGA, tubulovillous architecture and the presence of AIG as well as mixed immunophenotype. As the overall local recurrence rate is less than 10%, PGAs may be treated conservatively, but they should be excised completely if possible, particularly if they are large or show high‐grade features.