GI Path SG 2022 (student prep slides).pptx

GI

1. Gastrointestinal Pathology Pathology Small Group Renal, Endocrine, GI, Nutrition March 2022

2. Outline 3 clinicopathologic cases for discussion Rapid review (unknowns)

3. Case 1: A 10-year-old girl (she/her) with epigastric pain What are the notable clinical history, physical exam and laboratory findings? Do you expect to see endoscopic changes in the duodenum?

4. Duodenal biopsy (low power): Describe the findings Normal Patient

5. Duodenal biopsy (high power): Describe the findings

6. What is the diagnosis?

7. What is the next step in clinical management? What is the pathogenesis of this disease? Discussion questions

8. Case 2: A 65-year-old woman (she/her) with GI bleeding What are the notable clinical history, physical exam and laboratory findings? Why did the patient have a colonoscopy at age 50? What is the role of colonoscopy at this time?

9. Endoscopy of the descending colon: Describe findings Normal Patient

10. Describe the imaging findings

11. Discussion questions What is your leading diagnosis based on the findings thus far? The biopsy confirms your impression (images not shown). What is the next step in management?

12. Resection specimen: Describe the gross findings

13. Resection specimen (very low power, area of deepest invasion): Describe the findings

14. Resection specimen (mucosal surface, high power): Describe the findings Normal Patient

15. Resection specimen (pericolonic fat; low power): Describe the findings Patient Normal

16. Regional lymph node (low and medium powers): Describe the findings Patient Normal

17. Separately identified polyp (low power): Describe the findings

18. What are the diagnoses?

19. Discussion questions There is no clinical evidence of distant metastasis to another organ. What is the prognosis? What is the genetic basis of most cases of sporadic colon cancer? Contrast pathogenesis of the polyp to pathogenesis of the main finding.

20. Case 3: A 78-year-old man (he/him) with abdominal pain What are the notable clinical history, physical exam and laboratory findings? What is the differential diagnosis for the patient’s bleeding?

21. Endoscopy of the colon: Describe findings Normal Patient

22. CT for Case Patient Pay attention to the left colon!

23. Normal Case Patient Magnified images cyst

24. Descending colon biopsy (medium power): Describe findings Normal Patient

25. What is the diagnosis?

26. Discussion questions What are patients with this disease at risk for? What is the next step in clinical management? What is the pathogenesis of this disease?

27. RAPID REVIEW Name the disease process or finding based on the image(s) shown

28. Colon mass

29. Ileal biopsy

30. Duodenal biopsy

31. Colon polyp

32. Resected colon