Читать книгу Gastrointestinal Pathology - Группа авторов - Страница 4

1 Chapter 1Figure 1.1 Endoscope with control handle and tip. The tip contains a light s...Figure 1.2 Endoscopic processor, which converts the light captured from the ...Figure 1.3 (a) Tools for performing endoscopic resection including endoscopi...Figure 1.4 Endoscopic biopsy forceps in the open position. The needle‐like p...Figure 1.5 Micro biopsy forceps <1 mm in diameter, which can be passed throu...Figure 1.6 Endoscopic snare for polypectomy. The wire loop is extended in th...Figure 1.7 Endoscopic cytology brush. Note the abrasive brush extended beyon...Figure 1.8 Nonendoscopic abrasive cytology brush.Figure 1.9 (a) and (b) Endoscopic ultrasound endoscope and guided fine‐needl...Figure 1.10 Pinned and oriented resection tissue from Barrett's esophagus‐as...Figure 1.11 Barrett's esophagus with flat neoplasia (9 o'clock) for targeted...Figure 1.12 Multiband mucosectomy device. The black rubber bands are mounted...Figure 1.13 Area of resection at 6–12 o'clock includes the entire region of ...Figure 1.14 Endoscopic submucosal dissection (ESD) procedure. A flat neoplas...Figure 1.15 Endoscopically resected en bloc well‐differentiated adenocarcino...Figure 1.16 Large mediastinal lymph node sampled with EUS‐FNA. The needle is...

2 Chapter 2Figure 2.1 Endoscopic appearance of distal esophagus with normal squamous mu...Figure 2.2 Normal esophagus squamous mucosa with normal stratified non‐kerat...Figure 2.3 Endoscopic appearance of white exudate typical of Candida albican...Figure 2.4 Debris of slough off superficial squamous epithelium with fungal ...Figure 2.5 PAS stain of Figure 2.4 illustrating the fungal elements of Candi...Figure 2.6 Multinucleated basal keratinocytes typical of HSV esophagitis.Figure 2.7 Erosive esophagitis with prominent granulation and atypical cellu...Figure 2.8 High‐magnification evaluation of Figure 2.7 demonstrated (a) endo...Figure 2.9 Endoscopic appearance of erosive esophagitis in a patient with ga...Figure 2.10 Characteristic appearance of low‐power view of reflux esophagiti...Figure 2.11 High‐power magnification of reflux esophagitis with basal cell h...Figure 2.12 Endoscopic appearance of eosinophilic esophagitis (a) with so‐ca...Figure 2.13 Characteristic histology of eosinophilic esophagitis with basal ...Figure 2.14 Characteristic histology of lymphocytic esophagitis.Figure 2.15 Endoscopic appearance of inflammatory stricture of the esophagus...Figure 2.16 (a) Iron tablet erosive esophagitis with fibrinopurulent debris....Figure 2.17 Endoscopic appearance of necrotizing esophagitis with appearance...Figure 2.18 Characteristic appearance of sloughing esophagitis with two‐tone...Figure 2.19 Endoscopic appearance of acute GVHD of esophagus with diffuse mu...Figure 2.20 Endoscopic appearance of inflammatory stricture with persistent ...Figure 2.21 Microscopic appearance of acute GVHD of esophagus with basal apo...Figure 2.22 Endoscopic appearance of esophageal lichen planus with diffuse m...Figure 2.23 Esophageal granuloma in a previously diagnosed patient with Croh...

3 Chapter 3Figure 3.1 Endoscopic view of Barrett's esophagus. From upper left and clock...Figure 3.2 (a) Typical appearance of Barrett's esophagus with numerous goble...Figure 3.3 Barrett's esophagus indefinite for dysplasia. Nuclear hyperchroma...Figure 3.4 Low‐grade dysplasia. Note the sharp transition between nuclear hy...Figure 3.5 High‐grade dysplasia. The architectural features with back to bac...Figure 3.6 Crypt dysplasia. This lesion is characterized by neoplastic featu...Figure 3.7 (a) Foveolar dysplasia, low grade. This lesion is characterized b...Figure 3.8 Serrated dysplasia—note the serrated profile of the glands with l...Figure 3.9 (a) Intramucosal adenocarcionma—the lesion is characterized by di...Figure 3.10 Duplicated muscularis mucosae—note the inner and outer (duplicat...Figure 3.11 (a) Barrett's esophagus with high‐grade dysplasia in the 8–12 o'...Figure 3.12 Buried BE glands with low‐grade dysplasia. This phenomenon can b...Figure 3.13 Barrett's esophagus with high‐grade dysplasia showing p53 (left)...Figure 3.14 Squamous low‐grade dysplasia/intraepithelial neoplasia. Note the...Figure 3.15 (a) Squamous high‐grade dysplasia/intraepithelial neoplasia with...Figure 3.16 Basal layer dysplasia/intraepithelial neoplasia—note the basal a...Figure 3.17 (a) Schema of endoscopic and macroscopic classification of super...Figure 3.18 Schematic presentation of early and superficial esophageal cance...Figure 3.19 Well‐differentiated squamous cell carcinoma showing nests of aty...Figure 3.20 Basaloid squamous cell carcinoma characteristically showing pleo...Figure 3.21 Verrucous squamous cell carcinoma showing hyper‐ and parakeratos...Figure 3.22 Sarcomatoid squamous cell carcinoma. This picture shows atypical...Figure 3.23 Lugol's iodine staining in vivo of an early squamous cell carcin...Figure 3.24 Endoscopic appearance of an esophageal papilloma appearing as a ...Figure 3.25 Exophytic squamous papilloma showing delicate fibro‐vascular cor...Figure 3.26 Gastric heterotopia “inlet patch.” The salmon‐colored mucosa is ...Figure 3.27 Typical endoscopic image of heterotopic sebaceous glands in mid‐...Figure 3.28 Common histomorphological appearance of “inlet patch.”Figure 3.29 Heterotopic sebaceous glands. Note the typical vacuolated cytopl...Figure 3.30 Glycogenic acanthosis characterized by thickening of the epithel...Figure 3.31 Submucosal granular cell tumor showing a sharp demarcation to th...Figure 3.32 Granular cell tumors are typically immunohistochemically positiv...Figure 3.33 Esophageal leiomyoma (arrow) arising from the muscularis propria...Figure 3.34 Well‐defined submucosal leiomyoma with typical whorled fascicula...Figure 3.35 Leiomyosarcoma—fascicles of high cellularity with marked nuclear...Figure 3.36 Kaposi sarcoma with characteristic slit‐like spaces filled with ...

4 Chapter 4Figure 4.1 Endoscopic appearance of acute gastritis with superficial erosion...Figure 4.2 HP. Gastric antral biopsy with a severe population of Helicobacte...Figure 4.3 HP inflammation. H.E. stain of a punch biopsy with typical inflam...Figure 4.4 Acute erosive changes. Antral biopsy with superficial erosion and...Figure 4.5 Reactive gastropathy. Antral mucosa showing foveolar hyperplasia ...Figure 4.6 (a) Focally enhanced gastritis. Gastric antral mucosa with a smal...Figure 4.7 Autoimmune gastritis. Typical changes of mucosa of the body in th...Figure 4.8 Lymphocytic gastritis. Superficial high magnification of a gastri...Figure 4.9 Syphilitic gastritis. Higher magnification of a corpus biopsy sho...Figure 4.10 High magnification of CMV gastritis with typical cherry red nucl...Figure 4.11 Eosinophilic gastritis. Superficial biopsy of the antrum with a ...Figure 4.12 Collagenous gastritis. Antral mucosa showing a prominent submuco...Figure 4.13 Iron pill induced gastritis. Superficial antral mucosa with appe...Figure 4.14 Calcifying gastritis. Antral punch biopsy with erosive and react...Figure 4.15 Doxycycline erosive gastritis. The classic appearance is compose...Figure 4.16 (a) GvHD. Typical changes in longstanding GvHD showing multiple ...Figure 4.17 Chemoradiation. High magnification of a gastric mucosal biopsy w...Figure 4.18 Kayaxylate. Example of a chronic gastric ulcer caused by Kayaxal...Figure 4.19 GAVE. Antral mucosa with dilation changes of the capillaries and...Figure 4.20 Amyloidosis. Superficial gastric mucosa showing dense homogenous...

5 Chapter 5Figure 5.1 Single (a) or multiple (b) small translucent lesions covered by b...Figure 5.2 Fundic gland polyposis in familial adenomatous polyposis. There a...Figure 5.3 Low‐power photomicrograph of fundic gland polyp with multiple cys...Figure 5.4 Higher magnification of Figure 5.3 showing cystically dilated gla...Figure 5.5 Low‐grade (foveolar type) dysplasia in a sporadic fundic gland po...Figure 5.6 Endoscopic appearance of a large hyperplastic polyp covered by er...Figure 5.7 Low magnification of a hyperplastic polyp (a), showing gastric fo...Figure 5.8 Small pyloric type glands beneath the proliferating foveolar epit...Figure 5.9 Markedly proliferative serrated foveolar epithelium mimicking car...Figure 5.10 Adenomatous low‐grade dysplasia found in hyperplastic polyp show...Figure 5.11 Gastric biopsy from polypoid mass showing both hyperplastic poly...Figure 5.12 A small polypoid foveolar hyperplasia composed solely of prolife...Figure 5.13 Low‐power view of gastritis cystica polyposa.Figure 5.14 Gastric biopsy specimen with bland glands admixed with edematous...Figure 5.15 Adenocarcinoma observed in the herniated gastric mucosa in the s...Figure 5.16 Endoscopic view of a pedunculated gastric juvenile polypFigure 5.17 Typical microscopic features of intestinal type adenoma with low...Figure 5.18 Gastric foveolar type adenoma with low‐grade dysplasia (left) an...Figure 5.19 Gastric foveolar type adenoma with pale clear cytoplasm and high...Figure 5.20 Closely packed pyloric type glands lined by cuboidal/columnar ce...Figure 5.21 Endoscopic appearance of a pedunculated gastric juvenile polyp w...Figure 5.22 Cystically dilated glandular and foveolar elements in juvenile p...Figure 5.23 Endoscopically many sessile polyps are found in patients with Pe...Figure 5.24 Histomorphologically arborizing bundles of smooth muscles emerge...Figure 5.25 Adenocarcinoma developed in patients with hamartomatous polyposi...Figure 5.26 Gastric polyp in patient with Cowden's disease with foveolar hyp...Figure 5.27 Histomorphological appearance of a biopsy from a patient diagnos...Figure 5.28 A recently described finding in GAPPS are polyps showing hyperpr...Figure 5.29 Inflammatory fibroid polyp presenting as broad‐based submucosal ...Figure 5.30 Gastric biopsy specimen with proliferation of loose spindle cell...Figure 5.31 Immunohistochemical staining of the inflammatory fibroid polyp (...Figure 5.32 Submucosal aggregates of xanthoma cells with a distinct cell mem...Figure 5.33 Heterotopic pancreas on the posterior wall of the mid‐body, an s...Figure 5.34 In gastric pinch biopsies, observation of pancreatic acini in th...Figure 5.35 Gastric pinch biopsy of a patient with endoscopical appearance o...

6 Chapter 6Figure 6.1 Focal gastric neoplasia on lesser curvature of antrum shown in wh...Figure 6.2 Intestinal/adenomatous type dysplasia. (a) Low‐grade: It shows li...Figure 6.3 Gastric/foveolar/type 2 dysplasia. (a) Low‐grade: The lesion disp...Figure 6.4 When a diagnosis of high‐grade dysplasia or T1 carcinoma is made ...Figure 6.5 Well‐differentiated intramucosal adenocarcinoma. This example is ...Figure 6.6 Well‐differentiated adenocarcinoma of tubular type. The neoplasm ...Figure 6.7 Poorly differentiated adenocarcinoma of tubular type. It shows an...Figure 6.8 Mucinous adenocarcinoma with limited epithelial elements noted at...Figure 6.9 Signet ring cell gastric adenocarcinoma composed of individual si...Figure 6.10 EBER‐positive gastric adenocarcinoma. Marked lymphocytic infiltr...Figure 6.11 AFP‐producing gastric adenocarcinoma. Large polygonal eosinophil...Figure 6.12 Low‐grade NET (a) showing a mixed trabecular and nested growth p...Figure 6.13 Large cell neuroendocrine carcinoma composed of solid sheet of r...Figure 6.14 GIST, spindle cell variant. The lesion consists of interlacing f...Figure 6.15 GIST, epithelioid variant. The lesion shows distinctly round cel...Figure 6.16 Microscopic aspect of gastric MALT lymphoma. (a) Low magnificati...Figure 6.17 Gastric MALT lymphoma with plasma cell differentiation. (a) The ...Figure 6.18 IRTA1 expression in gastric MALT lymphoma. Positive staining in ...Figure 6.19 Control gastric biopsies after antibiotic therapy for H. pylori‐...Figure 6.20 Primary gastric diffuse large B‐cell lymphoma presenting as a vo...Figure 6.21 Diffuse large B‐cell lymphoma of the stomach. (a) Low‐power view...Figure 6.22 Primary gastric “double‐hit” high‐grade B‐cell lymphoma with MYCFigure 6.23 Mantle cell lymphoma diagnosed on gastric biopsies in a 80‐year‐...Figure 6.24 Primary gastric sporadic Burkitt lymphoma, EBV‐negative, in a 34...Figure 6.25 Gastric involvement by an extranodal NK/T‐cell lymphoma nasal‐ty...

7 Chapter 7Figure 7.1 (a) Duodenal intraepithelial lymphocytosis with normal villous ar...Figure 7.2 Microvillous inclusion disease with vacuolization of surface epit...Figure 7.3 Electron microscopic image characteristic of the microvillous inc...Figure 7.4 Histologic evidence of a tufting enetropathy.Figure 7.5 Duodenal giardiasis. Note the variable shapes of the organisms in...Figure 7.6 Cryptosporidiosis with secondary lymphocytosis. Observe the organ...Figure 7.7 Example of strongyloides in the duodenal crypts.Figure 7.8 Low‐power view of MAI‐associated enteritis with diffuse histiocyt...Figure 7.9 (a–c) Example of Whipple's disease, characterized by infiltration...Figure 7.10 (a) Adenovirus infection with typical eosinophilic intranuclear ...Figure 7.11 CMV duodenitis with classic CMV inclusions in endothelial cell c...Figure 7.12 Endoscopic celiac disease with scalloping of the duodenal folds....Figure 7.13 Example of celiac disease, Marsh grade 1 with the characteristic...Figure 7.14 Marsh grade 3a of celiac disease with definite villous blunting....Figure 7.15 Low‐power view of autoimmune enteropathy characterized by blunti...Figure 7.16 Example of a tropical sprue with intraepithelial lymphocytosis a...Figure 7.17 Collagenous sprue with obvious expansion of the lamina propria b...Figure 7.18 Example of Crohn's ileitis with deep serpiginous ulceration, ery...Figure 7.19 Microscopic evidence of active Crohn's ileitis (a) and granuloma...Figure 7.20 NSAIDs enteropathy with superficial erosion and multifocal white...Figure 7.21 Example of the Waldenstrom disease with expansion of the lamina ...Figure 7.22 Amyloid deposition resulting in the expansion of the lamina prop...

8 Chapter 8Figure 8.1 Gastric heterotopia of the proximal duodenal bulb. Note the surfa...Figure 8.2 Gastric heterotopia. Note the surface foveolar epithelium and oxy...Figure 8.3 Pancreatic heterotopia. In this example, the heterotopia is uniqu...Figure 8.4 Ampullary adenomyoma. The lesion is composed of benign ductular e...Figure 8.5 Hamartomatous polyps in a patient with Peutz–Jeghers syndrome. Th...Figure 8.6 Intestinal pseudopolyps in a patient with inflammatory bowel dise...Figure 8.7 Brunner's gland cyst. The lesion is located underneath the mucosa...Figure 8.8 Juvenile polyp.Figure 8.9 Examples of Cronkhite–Canada polyps showing a spectrum of changes...Figure 8.10 Arteriovenous malformations detected in small bowel on capsule e...Figure 8.11 Lymphangiectasia. Note the dilated lymphatic channels containing...

9 Chapter 9Figure 9.1 Endoscopic Brunner gland adenoma in the proximal duodenum.Figure 9.2 Brunner gland hamartoma.Figure 9.3 Endoscopic appearance of pyloric gland adenoma.Figure 9.4 Pyloric gland adenoma of duodenum.Figure 9.5 Tubular adenoma of duodenum.Figure 9.6 (a) Hyperplastic polyp of duodenum. (b) Serrated adenoma of duode...Figure 9.7 Adenocarcinoma of intestinal type arising in neurofibromatosis wi...Figure 9.8 Pancreatic type adenocarcinoma in ampulla.Figure 9.9 (a) NET of the duodenum. (b) Chromogranin IHC in duodenal NET.Figure 9.10 Endoscopic US image of GCPG. The lesion is hypoechoic (dark) ari...Figure 9.11 (a) Gangliocytic paraganglioma H&E MP. (b) Gangliocytic paragang...Figure 9.12 Small GIST (1–2 cm) at 1 o'clock. The lesion arises from the fou...Figure 9.13 GIST composed of short fascicles.Figure 9.14 Inflammatory fibroid polyp of ileum LP.Figure 9.15 (a) Follicular lymphoma duodenum H&E. (b) Follicular lymphoma CD...Figure 9.16 Mantle cell lymphoma ileum HP 2.Figure 9.17 (a) Mantle cell lymphoma CD20. (b) Mantle cell lymphoma ileum CD...Figure 9.18 Burkitt lymphoma ileum.Figure 9.19 (a) IPSID. (b) IPSID CD138.Figure 9.20 (a) Mastocytosis rich in eosinophils. (b) CD117 mastocytosis. (c...

10 Chapter 10Figure 10.1 Biopsies of acute self‐limiting colitis (ASLC) show a preserved ...Figure 10.2 Colonic biopsy affected by Mycobacterium tuberculosis showing mu...Figure 10.3 Typical appearance of a spirochetosis of the colon showing a pur...Figure 10.4 H.E. stain of the colon showing typical changes caused by CMV in...Figure 10.5 Biopsy specimens of pseudomembranous colitis showing the whole s...Figure 10.6 Example of a severe amebiasis showing a severe ulcerative coliti...Figure 10.7 High magnification of a colon biopsy with a population of crypto...Figure 10.8 H.E. stain of a colonic biopsy with manifestation of Schistosoma...Figure 10.9 H.E. stain of Syphilitic colitis (a) with a predominant lymphopl...Figure 10.10 Typical histological appearance of an early (a) and a late (b) ...Figure 10.11 H.E. stain of FAC characterized by inflammation driven by neutr...Figure 10.12 Typical finding in case of collagenous findings showing a thick...Figure 10.13 High magnification of lymphocytic colitis characterized by an i...Figure 10.14 Characteristic changes in colonic biopsies caused by mucosal pr...Figure 10.15 High magnification of a colonic biopsy with changes characteris...Figure 10.16 Example of mastocytic colitis showing a slightly increased mixe...Figure 10.17 Mycrophenolate mofetil‐related colitis is a pitfall mimicking c...Figure 10.18 Endoscopic appearance of severe Crohn's disease. (a) Deep ulcer...Figure 10.19 Endoscopic appearances of ulcerative colitis: (a) severe ulcera...Figure 10.20 Colonic mucosa with typical architectural disarray caused by UC...Figure 10.21 Colonic mucosa of UC showing a dense lymphoplasmacytic infiltra...Figure 10.22 Typical inflammatory changes of an active UC showing crypt absc...Figure 10.23 Specimen of a long‐standing UC under therapy showing scattered ...Figure 10.24 Hisological appearance of a Crohn's patient showing a dense inf...Figure 10.25 Small epithelioid granuloma found in the lamina propria of a co...Figure 10.26 Low‐grade IBD‐associated dysplasia. This lesion shows a convent...Figure 10.27 High‐grade IBD‐associated dysplasia shows crowded, focally back...Figure 10.28 Hypermucinous dysplasia typically shows a villous/tubulovillous...Figure 10.29 IBD‐associated TSA‐like dysplasia presents with narrow, slit‐li...Figure 10.30 Example of goblet cell‐deficient dysplasia (GCD) with tubular c...

11 Chapter 11Figure 11.1 Tubulovillous adenoma with high‐grade dysplasia. Features sugges...Figure 11.2 Paris Classification of polyp shape. 0–1p refers to pedunculated...Figure 11.3 Narrow‐band imaging International Classification for Endoscopy...Figure 11.4 Hematoxylin–Eosin stain of a tubulovillous adenoma with high‐gra...Figure 11.5 Endoscopic resection of sessile serrated polyp (a) with standard...Figure 11.6 Hyperplastic polyp as seen in narrow‐band imaging model. Note th...Figure 11.7 Hyperplastic polyp presenting as a localized projection of the c...Figure 11.8 Sessile serrated lesion displaying horizontally shaped crypt bas...Figure 11.9 Sessile serrated lesion with dysplasia. This lesion was atypical...Figure 11.10 Sessile serrated lesion with dysplasia. There is a clear demarc...Figure 11.11 Endoscopic appearance of a rectal polyp being diagnosed as a trad...Figure 11.12 Traditional serrated adenoma with villous projections, ectopic ...Figure 11.13 Endoscopic examples of (a) inflammatory and (b) filiform pseudo...Figure 11.14 Typical histomorphology of a juvenile polyp with haphazardly cy...Figure 11.15 Hamartomatous polyp in a patient with Peutz–Jeghers syndrome ch...Figure 11.16 Microscopic appearance of a colonic mucosal leiomyoma with its ...Figure 11.17 Histology of a submucosal lipoma with benign well‐circumscribed...Figure 11.18 Endoscopic ultrasound (EUS) image of a lipoma arising in the su...Figure 11.19 Combined fibroblastic polyp and SSL with fibrotic changes of th...Figure 11.20 Colonic polyp with collagen bundles and thick eosinophilic elas...Figure 11.21 Colonic polypoid endometriosis with its typical glands being su...

12 Chapter 12Figure 12.1 Cecal polyp showing invasion of the lamina propria by small atyp...Figure 12.2 Various macroscopic appearances of colorectal carcinoma presenti...Figure 12.3 Medullary carcinoma of the proximal colon consisting of sheets o...Figure 12.4 Loss of immunohistochemical expression of MLH1 in a medullary ca...Figure 12.5 Metastatic melanoma in the sigmoid colon: infiltration of the co...Figure 12.6 Endometriosis presenting as a large mass in the upper rectum, mi...Figure 12.7 Endometriosis in the rectal mucosa: Endometrial glands surrounde...Figure 12.8 (a) Endoscopical appearance of malignant sessile colon polyp wit...Figure 12.9 Pseudoinvasion in the stalk of a large pedunculated tubular aden...Figure 12.10 NET of the rectum showing an anastomosing ribbon pattern infilt...Figures 12.11 and 12.12 Large cell neuroendocrine carcinoma of the rectum sh...Figures 12.13 and 12.14 Endoscopic appearance of mucosal‐associated lymphoid...

13 Chapter 13Figure 13.1 Example of anal fissure lined by inflamed granulation tissue and...Figure 13.2 (a) Large external hemorrhoid seen via anoscopy. A snare device ...Figure 13.3 Anal involvement by Crohn's disease with granulomatous inflammat...Figure 13.4 (a) Syphilis proctitis: Cryptitis and expanded lamina propria in...Figure 13.5 (a) Columnar mucosa with expanded lamina propria inflammatory in...

14 Chapter 14Figure 14.1 (a) Inflammatory cloacogenic polyp: The polyp is composed of elo...Figure 14.2 Fibroepithelial polyp: The polyp has a core containing variably ...Figure 14.3 (a) Hidradenoma papilliferum: A submucosal proliferation of papi...Figure 14.4 Squamous hyperplasia: The squamous mucosa has acanthosis (thicke...Figure 14.5 (a) Condyloma acuminatum: There is acanthosis of the squamous mu...Figure 14.6 Anal intraepithelial neoplasia grade 1/low‐grade squamous intrae...Figure 14.7 Anal intraepithelial neoplasia grade 3/high‐grade squamous intra...Figure 14.8 (a) Perianal Paget's disease: Paget's cells are scattered throug...Figure 14.9 Endoscopic view of anal squamous cell carcinoma at the 6 o'clock...Figure 14.10 (a) Invasive squamous cell carcinoma, keratinizing, with infilt...Figure 14.11 Malignant melanoma: Panel A shows a densely cellular lesion adj...