Gastrointestinal pathology emerged as a subspecialty in the early 1980s, coincident with the development of endoscopy and mucosal biopsy for diagnosis and management of patients with gastrointestinal disorders. Since that time, changes in tissue acquisition techniques and ancillary testing have drastically transformed the discipline; current practice bears little resemblance to that of our mentors. The past two decades have seen an explosion in the number and types of biopsy samples pathologists encounter in daily practice. Virtually every part of the tubular gut is now amenable to visualization and sampling, and most liver biopsies are performed by radiologists who utilize small-caliber needles. As a result, pathologists are expected to generate comprehensive and accurate differential diagnoses for a variety of inflammatory and neoplastic disorders based on limited biopsy material. Pathologists must be able to hone in on key features in order to narrow the differential diagnosis and facilitate patient management.
Learning Objectives
- Improve criteria for interpretation of mismatch repair protein immunohistochemistry
- Streamline utilization of ancillary tests in evaluation of lymphoid infiltrates of the GI tract
- Formulate an appropriate differential diagnosis for chronic hepatitis
- Distinguish between medication-related injury and other inflammatory conditions of the GI tract
- Explore various neoplasms that affect the gastrointestinal tract, liver and pancreas
