Histo-Meeting 23.10.2013
Index Cap polyps Crohn s disease Stomach resection Gastric MALT lymphoma Cloacogene polyp of the rectum Histo-Meeting October 23, 2013 2
53 year old male patient 1. Neurofibromatosis Typ I (von Recklinghausen) 2. Multiple intestinal polyps from various aetiology Subtotal colectomy 1991 with ileorectal anastomosis Colonoscopy 11/2009: progression in size and numbers of intestinal polyps Last polypectomy 03/2011: 7 Polyps, multiple polyps in distal ileum (0.5-3cm) Colonoscopy 08/2013 sign of «Outlet-obstruction» Histo-Meeting October 23, 2013 3
Colonoscopy 08/2013 Histo-Meeting October 23, 2013 4
Histology subepithelial mixed inflammation; intact mucosa no adenomatous process, no dysplasia, no malignancy Typical cap -polyps, often encountered next to anastomosis. Histo-Meeting October 23, 2013 5
33 year old male patient Crohn s disease (firstly diagnosed 1990) - Laparotomy small bowel resection due to stenosis and fistulas 2005 - Repeated dilatations ileocecal stenosis 2009 2012 - Recent therapy: adalimumab, methotrexat Recent problem: Dysphagia, responding to PPI Histo-Meeting October 23, 2013 6
EGD ulcerative anitis Anastomosis with stenosis in the duodenum Histo-Meeting October 23, 2013 7
Histology Hyperplasia Brunner glands, capillar ectasia Probably sampling error Slight, unspecific gastric inflammation Histo-Meeting October 23, 2013 8
58 year old female patient - St.n. duktalem Carcinoma in situ der Mamma rechts, G2, ED 11/2006 - Non-Hodgkin-Lymphom des Magens mit Gastrektomie nach Billroth II, 1985 + St.n. Radio-Chemotherapie - Hospitalisation im September 2013 bei konservativ behandelter Cholezystitis - 25.09.2013 ÖGD: Histo-Meeting October 23, 2013 9
58 year old female patient 11.10.2013: Restgastrektomie mit Dünndarmsegmentresektion, distaler Oesophagusresektion (5cm) und D2 Lymphadenektomie. Diagnose: Adenokarzinom des Magens vom diffusen Typ nach Lauren proximal der Magen-Dünndarmanastomose pt1a, pn0 (0/14), L0, V0, Pn0, R0, G3 Keine Nachsorge Histo-Meeting October 23, 2013 10
HE: signet ring cells Immunohistochemistry pancytoceratine: positive for signet ring cells (plus CDX 2 homeobox gene proofs gastrintestinal origine) Histo-Meeting October 23, 2013 11
63 year old female patient - Sjögren`s syndrom, metabolic syndrome, cholestatic hepatopathia - Clinical presentation: weight loss (-15kg), dysphagia Histo-Meeting October 23, 2013 12
Gastroscopy 06.09.13: Antral redness Histo-Meeting October 23, 2013 13
Gastric antral mucosa: Lymphocytic infiltration of the antral mucosa CD 20 pos. periglandular lymphocytes, susp. of MALTlymphoma Histo-Meeting October 23, 2013 14
72 year old female patient Fresh blood on stools Minimal normochrome normocytic anemia Previous hemicolectomy 2009 because of repeated diverticulitis Histo-Meeting October 23, 2013 15
Colonoscopy Flat polyp of the distal rectum/anal Diverticulosis Histo-Meeting October 23, 2013 16
Cloacogenic polyp Bundles of muscularis mucosae reaching in to the squamous epithelium, Colorectal mucosa Squamous epithelium Histo-Meeting October 23, 2013 17