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Snippets in surgical pathology
  1. Kumarasen Cooper (kum.cooper@vtmednet.org),
  2. Runjan Chetty (runjan.chetty@uhn.on.ca)

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This section features synopses of pertinent practical publications that appear in pathology journals in the respective sub-specialties. The summaries are mere guidelines and personal opinions of the two authors. The articles selected are diverse but occasionally reflect the authors’ bias and are from the more widely read pathology journals. It is not intended to be an assiduous search of every publication in every pathology journal, but more of a general indication of some of the monthly highlights through the eyes of the authors.

Hopefully, these snippets will provide the reader with enough to glean some facts and tips, as well as encourage them to read the entire article if necessary.

Journal of Clinical Pathology, March 2009

Geboes K, van Eyken P. Inflammatory bowel disease unclassified and indeterminate colitis: the role of the pathologist. J Clin Pathol 2009;62:201–5.

An often difficult diagnosis that we should only resort to in colectomy specimens (not biopsies as the vast majority of cases will fall into this wastebasket!) is that of “indeterminate colitis”. This paper reviews the current controversies related to this diagnosis with the role of the pathologist outlined. This review also provides an algorithm for the diagnosis of colitis with a focus of indeterminate colitis. In addition, there are two very handy tables on cause of chronic non-inflammatory and chronic inflammatory diarrhoea. The most telling statements are contained in the first four lines of the last paragraph: “most patients with IBDU (inflammatory bowel disease unclassified) will eventually develop ulcerative colitis. The correct diagnosis implies a close collaboration between the pathologist and the gastroenterologist and can be reached with careful clinical follow-up…”

From my perspective as a gastrointestinal pathologist (RC), I have found making a diagnosis of indeterminate colitis excruciatingly difficult and often throw the ball back into my clinical colleagues’ laps!

Luk A, Ahn E, Soor GS, …

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