Session 11

 

Sunday, September 3
2:00 – 4:00 pm

Room 2

 

 

Hot topics in esophageal pathology

 

Chairs: ILKe Nalbantoglu (USA) – Maria Westerhoff (USA)

Discussant: Henry D. Appelman (USA)

 

Eosinophilic esophagitis (EoE)

• What is the rationale for the choice of 15 eosinophils per HPF as the cutoff for diagnosis?
  Heather Dawson (Switzerland)
• How many biopsies are needed to exclude the diagnosis of EoE with confidence, and how big should they be? Dhanpat Jain (USA)
• What do degranulated eosinophils in the squamous epithelium mean in terms of diagnosis of EoE?
  Paul E. Swanson (Canada)
• Is there any evidence that biopsies of endoscopically normal mucosa are cost effective in the diagnosis of EoE? Xuchen Zhang (USA)
• Is EoE with normal esophagus endoscopically the same as EoE with typical endoscopic findings?
  Rebecca Wilcox (Canada)
• Is it important to diagnose fibrosis of the lamina propria in EoE biopsies? Hala El-Zamaity (Canada)

 

Lymphocytic esophagitis

• In the absence of an esophageal motility disorder, does the histologic diagnosis of lymphocytic esophagitis have any clinical meaning? Rhonda K. Yantiss (USA)
• In order to diagnose lymphocytic esophagitis, is it necessary that careful counts of intra-epithelial lymphocytes be performed? Suntrea T. Hammer (USA)
• Is lymphocytic esophagitis with the endoscopic appearance of EoE a specific disease?
  Deepa T. Patil (USA)
• What is the natural history of lymphocytic esophagitis? Rupert Langer (Switzerland)
  
  

Is reflux esophagitis ever a histologic diagnosis? A debate

Yes     --------------       No
Cathy S. Streutker (Canada)             Monika Tripathi (UK)

Other inflammations

• What drugs commonly induce endoscopic and histologic changes in the esophagus?
  Purva Gopal (USA)
• Is there an acute esophageal bacterial infection, and what does it look like in biopsies?
  Mikhail Lisovsky (USA)
• What are the histologic esophageal manifestations of dermatologic diseases? Joanna Gibson (USA)
• What are the causes of sloughing esophagitis (esophagitis dessicans superficialis)?
  ILke Nalbantoglu (USA)

 

Columnar topics

• There is a 1.5 cm length of endoscopic columnar mucosa in the distal esophagus. Eight (8)  biopsies contain columnar mucosa that does not have a single goblet cell. In the UK, this is Barrett’s mucosa, but what is it in the US? Robert H. Riddell (Canada)
• Pancreatic acinar cells are common in biopsies of the cardia. We refer to them as a metaplasia. What is the proof that they are metaplastic rather than simply being a normal variant? Maria Westerhoff (USA)
• Why, following injury such as reflux, is it necessary for metaplastic columnar mucosa to develop, and what is the purpose of the goblet cells? Andrew M. Bellizzi (USA)
• Should all irregular Z-lines be biopsied in order to detect intestinal metaplasia?
  Sara Hafezi Bakhtiari (Canada)
• What is the significance of intestinal metaplasia in the esophagus that is less than 1 cm long?
  E. Celia Marginean (Canada)

 

Unique case discussions

• Pseudo-angiomatous SCC. Rebecca Wilcox (Canada)
• Carcinoma cuniculatum: how can one make a confident diagnosis on biopsy?
  Geneviève Soucy (Canada)