Christina Arnold - Atlas of Gastrointestinal Pathology: A Pattern Based Approach to Non-Neoplastic Biopsies

CHRISTINA A. ARNOLD, MD

Assistant Professor

Department of Pathology

Division of Gastrointestinal and Liver Pathology

Division of Bone and Soft Tissue Pathology

The Ohio State University Wexner Medical Center

Columbus, Ohio

DORA M. LAM-HIMLIN, MD

Assistant Professor

Department of Laboratory Medicine and Pathology

Mayo Clinic

Scottsdale, Arizona

ELIZABETH A. MONTGOMERY, MD

Professor of Pathology, Oncology, and Orthopedic Surgery

Department of Pathology

Division of Gastrointestinal and Liver Pathology

Johns Hopkins Medical Institutions

Baltimore, Maryland

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Printed in China.

Library of Congress Cataloging-in-Publication Data

Arnold, Christina A., author.

Atlas of Gastrointestinal Pathology: A Pattern Based Approach to Non-Neoplastic Biopsies / Christina A. Arnold, Dora M. Lam-Himlin, Elizabeth A. Montgomery.

p. ; cm.

Includes bibliographical references.

ISBN 978-1-4511-8810-3 (hardback)

I. Lam-Himlin, Dora M., author. II. Montgomery, Elizabeth (Elizabeth A.), 1958- author. III. Title.

[DNLM: 1. Gastrointestinal DiseasespathologyAtlases. 2. Gastrointestinal TractpathologyAtlases. WI 17]

RC802.9

616.3307dc23

2014017635

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LWW.com

To Michael, my always best friend.

To Madelyn and Jackson, Dream Big!

Christina A. Arnold, MD

To Matt, for being there.

To Madeline, for your big questions.

To Matthew, for wanting to eat a juvenile polyp.

Dora M. Lam-Himlin, MD

To the fresh ideas and success of all past, present, and future gastrointestinal pathology fellows.

Elizabeth A. Montgomery, MD

MICHAEL A. ARNOLD, MD, PhD

Assistant Professor

Department of Pathology and Laboratory Medicine

Nationwide Childrens Hospital

Department of Pathology

The Ohio State University Wexner Medical Center

Columbus, Ohio

BERKELEY N. LIMKETKAI, MD

Assistant Professor

Department of Medicine

Division of Gastroenterology and Hepatology

Stanford University

Stanford, California

CHRISTINA A. ARNOLD, MD

Assistant Professor

Department of Pathology

Division of Gastrointestinal and Liver Pathology

Division of Bone and Soft Tissue Pathology

The Ohio State University Wexner Medical Center

Columbus, Ohio

DORA M. LAM-HIMLIN, MD

Assistant Professor

Department of Laboratory Medicine and Pathology

Mayo Clinic

Scottsdale, Arizona

ELIZABETH A. MONTGOMERY, MD

Professor of Pathology, Oncology, and Orthopedic Surgery

Department of Pathology

Division of Gastrointestinal and Liver Pathology

Johns Hopkins Medical Institutions

Baltimore, Maryland

As soon as a junior trainee opens a textbook, he/she quickly realizes that most traditional text books rarely capture the true spectrum of pathology encountered through routine sign-out. The pathology that exists in textbooks is beautiful, perfect, and free from distracting artifacts. No doubt, these perfect examples facilitate the teaching process. The pathology that exists in real life, however, is messy. The tissue is often scanty, squashed, burnt, and cursed with artifacts. In real life, we have to search for red flags in the clinical chart, hidden clues in the slides, and discern an exacting diagnosis despite sometimes disabling artifacts.

This book project grew out of a need to teach pathology in a format that more closely mirrors daily sign-out. More than 1,100 images are included to illustrate the full morphologic spectrum of the major patterns of non-neoplastic gastrointestinal tract injury. Instead of one picture to illustrate chronic colitis, for example, this book includes over eighty; each image captioned with a careful description. The corresponding text details how to recognize the chronic colitis pattern and then how to translate the vague diagnosis of chronic colitis into the clinically meaningful diagnosis of syphilitic proctitis, for example, and how to avoid the diagnostic pitfall of inflammatory bowel disease.

In this book, disease processes are grouped by their histologic pattern of injury, an approach which closely approximates the method by which experienced pathologists mentally approach daily sign-out. Because the luminal gastrointestinal tract has a limited repertoire of responses to injury, one need master only a limited number of histologic patterns in order to elaborate the differential diagnoses. Organized by these major injury patterns, each chapter details etiologic considerations for the esophagus, stomach, small intestine, and colon.