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Lack of uniformity in reporting autoimmune gastritis among a diverse group of pathologists.
Bloomquist, M Suzanne; Powell, John; Masand, Ramya P; Dhall, Deepti; Karamchandani, Dipti M; Jain, Shilpa.
Affiliation
  • Bloomquist MS; Department of Pathology & Immunology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA. Electronic address: maria.bloomquist@bcm.edu.
  • Powell J; Department of Pathology & Immunology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA. Electronic address: john.powell@bcm.edu.
  • Masand RP; Department of Pathology & Immunology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA. Electronic address: ramya.masand@bcm.edu.
  • Dhall D; University of Alabama at Birmingham, 619 19th St S, Birmingham, AL 35233, USA. Electronic address: ddhall@uabmc.edu.
  • Karamchandani DM; Penn State Health Milton S. Hershey Medical Center, 500 University Dr., Hershey, PA 17033, USA. Electronic address: dkaramchandani@pennstatehealth.psu.edu.
  • Jain S; Department of Pathology & Immunology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA. Electronic address: shilpa.jain@bcm.edu.
Ann Diagn Pathol ; 56: 151840, 2022 Feb.
Article in En | MEDLINE | ID: mdl-34773775
ABSTRACT
Autoimmune gastritis (AIG) is a clinicopathologic diagnosis requiring characteristic histopathology and correlation with laboratory work-up. To better understand how the diagnosis of AIG is made and reported in the pathology community, we conducted an anonymous web-based survey which was circulated among a diverse group of pathologists. Excluding trainees there were 64 respondents 25 academic gastrointestinal pathologists (AGI, 39%), 22 academic general pathologists (AGP, 34%), 17 private general pathologists (PP, 27%). Our survey results highlighted variations in work-up and sign-out practices. The type of metaplasia needed to diagnose AIG lacked consensus. There was variation in accurate interpretation of immunostains with a trend towards more accurate diagnosis of enterochromaffin-like (ECL) cell hyperplasia by AGI (92%) and AGP (95%) than PP (71%) (p = 0.07). G-cells in antrum on neuroendocrine immunostain, a mimicker of ECL cell hyperplasia, was more frequently misdiagnosed by PP/ AGP (44%), versus AGI (12%) (p = 0.02). A triple immunostain panel (H. pylori, neuroendocrine, gastrin) was used in the work-up of AIG by 72% of AGI versus 23% AGP and 12% PP (p = 0.000061). The less-specific term "atrophic gastritis" was used in the diagnostic line more by respondents with >10 years sign-out experience compared with others (p = 0.04). In conclusion, the survey results highlighted deficiencies in the interpretation of neuroendocrine immunostains which is crucial for AIG diagnosis, as well as variation in reporting practices and definitions. Uniform criteria and terminology are needed in this field to improve communication with clinicians, resulting in appropriate testing and follow-up.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Autoimmune Diseases / Pathologists / Gastric Mucosa / Gastritis Limits: Humans Language: En Journal: Ann Diagn Pathol Journal subject: PATOLOGIA Year: 2022 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Autoimmune Diseases / Pathologists / Gastric Mucosa / Gastritis Limits: Humans Language: En Journal: Ann Diagn Pathol Journal subject: PATOLOGIA Year: 2022 Document type: Article
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