Morson and Dawson's Gastrointestinal Pathology E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 3512

Veröffentlichungsjahr: 2024

Beschreibung

The gold standard in gastrointestinal pathology textbooks returns

More than 34 million Americans suffer from pathologies of the digestive system, with over 20 million of these disorders chronic. Treatment of these patients is a complex multidisciplinary area of clinical medicine, drawing upon expertise not only from specialist gastroenterologists but also pathologists, immunologists, endoscopists, and more. Morson & Dawson’s Gastrointestinal Pathology has long set the standard for pathology textbooks, with its distinctive balance of clinical gastroenterology and pathology. Now fully updated to reflect the latest research in this vital field of medicine, it promises to bring this subject to a new generation of clinicians and pathologists worldwide.

Readers of the sixth edition of Morson and Dawson’s Gastrointestinal Pathology will also find:

• Contemporary recommendations and guidelines for getting the most out of every pathology specimen and producing the best possible report for managing the patient
• Discussions of the evolving applications of immunohistochemistry and in situ hybridisation
• A completely new chapter on lymphoid and other tumours of the large intestine

Morson & Dawson’s Gastrointestinal Pathology is ideal for gastrointestinal pathologists, general pathologists, gastroenterologists, and any clinicians who work with or in gastrointestinal practice.

Leseprobe

Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

Dedication

Contributors

Foreword

Preface and Acknowledgements

About the companion website

PART 1: Oesophagus

CHAPTER 1: The normal oesophagus: anatomy, specimen dissection and histology relevant to pathological practice

Anatomy

Histology

Handling of endoscopic and resection oesophageal specimens

References

CHAPTER 2: Normal embryology, foetal development and developmental abnormalities

Embryology and foetal development

Anomalies of development

Atresia, stenosis and tracheo‐oesophageal fistula

Oesophago‐bronchial fistula and pulmonary sequestration

Heterotopias

Congenital diaphragmatic hernia

Anterior and posterior rachischisis

Laryngo‐tracheo‐oesophageal cleft

References

CHAPTER 3: Neuromuscular and mechanical disorders of the oesophagus

Classification

Progressive systemic sclerosis (scleroderma)

Primary muscle disorders

Oesophago‐gastric outflow obstruction and other motility disorders of the oesophagus

Achalasia

Diverticula, rings and webs

Acquired hiatus hernia

Muscular and connective tissue changes associated with eosinophilic oesophagitis

References

CHAPTER 4: Inflammatory disorders of the oesophagus

Classification

Reflux oesophagitis

Infective oesophagitis

Eosinophilic oesophagitis

Drug‐ and chemical‐induced oesophagitis

Sloughing oesophagitis

Radiation oesophagitis

Crohn’s disease

The lymphocytic pattern of oesophagitis

Oesophagitis associated with skin disease

Graft‐versus‐host disease

References

CHAPTER 5: Barrett’s oesophagus

Introduction

Definition and diagnosis

The significance of intestinal metaplasia

Glandular phenotypes

Biopsy evaluation of dysplasia in Barrett’s oesophagus

Endoscopic resection specimens

The effects of treatment

References

CHAPTER 6: Polyps and tumour‐like lesions of the oesophagus

Inflammatory/hyperplastic polyp

Giant fibrovascular polyp

Glycogenic acanthosis

Leiomyomatosis

Squamous papilloma

References

CHAPTER 7: Tumours of the oesophagus

Adenoma and polypoid glandular dysplasia

Benign salivary‐gland‐type tumours

Malignant epithelial tumours

Epidemiology of oesophageal cancer

Predisposing risk factors for oesophageal cancer

Squamous‐cell carcinoma

Adenocarcinoma

References

CHAPTER 8: Miscellaneous conditions of the oesophagus

Cervical inlet patch

Trauma

Oesophageal casts

Black oesophagus

Varices

Webs and rings

Barium sulphate in the oesophagus

References

PART 2: Stomach

CHAPTER 9: The normal stomach: anatomy, histology, and specimen dissection relevant to pathological practice

General function

Position in the body

Zones of the stomach

Layers of the gastric wall

Neural networks of the gastric wall and interstitial cells of Cajal

Vasculature

Lymphatics and lymph nodes

Relationship with endoscopic findings

Specimen handling and dissection

References

CHAPTER 10: The stomach: normal embryology, foetal development and developmental abnormalities

Normal embryology and foetal development

Developmental abnormalities

References

CHAPTER 11: Inflammatory disorders of the stomach

Introduction

The effects of injury on the gastric mucosa

Classification of gastritis

Gastritis with prominent lamina propria inflammation

Gastritis with limited lamina propria inflammation

Gastric inflammatory pathology in the immunocompromised

Organisms incidentally identified on gastric histology

The gut microbiome in gastric inflammatory disorders

References

CHAPTER 12: Polyps and tumour‐like lesions of the stomach

Introduction

Epidemiology of gastric polyps

Classification of gastric polyps

Fundic gland polyps

Adenoma

Gastric neuroendocrine tumours

Polypoid carcinomas

Polyps developing in the setting of polyposis

Lipoma

Xanthoma

Gastric heterotopic pancreas

Ménétrier disease

Polyp‐like lesions

References

CHAPTER 13: Epithelial tumours of the stomach

Preneoplastic lesions

Malignant epithelial tumours

Prognosis and staging of gastric cancer

Hereditary gastric cancer syndromes

Molecular aspects of gastric carcinoma

Gastric neuroendocrine neoplasms

Secondary (metastatic) neoplasms in the stomach

References

CHAPTER 14: Stromal tumours of the stomach

Overview

Gastrointestinal stromal tumours

Tumours of neural origin

Tumours of smooth‐muscle origin

Vascular and perivascular tumours

Tumours of adipose tissue

Other mesenchymal tumours of interest

References

CHAPTER 15: Lymphoid tumours of the stomach

Introduction

Primary gastric lymphomas

Secondary lymphomatous involvement

Miscellaneous haematological malignancies

References

CHAPTER 16: Miscellaneous conditions of the stomach

Acute gastric dilatation

Motility disorders

Amyloid

Gastric bezoars

Gastric hyalinisation

Pseudo‐lipomatosis

Pseudo‐xanthoma elasticum

Graft‐versus‐host disease

Vascular disorders

Gastric mucosal siderosis

Pseudo–signet ring cells

Langerhans cell histiocytosis

Crystal‐storing histiocytosis

References

PART 3: Small Intestine

CHAPTER 17: Normal small intestine: anatomy, specimen dissection and histology relevant to pathological practice

Gross anatomy

Microscopic anatomy

Distinctive regional histological characteristics

Physiology

References

CHAPTER 18: Congenital abnormalities of the small intestine

Normal development

Malformations

Malrotation and malfixation

Heterotaxia syndrome (e.g. situs inversus and Kartagener’s syndrome)

Omphalocoele (exomphalos) and related defects

Maldevelopment

References

CHAPTER 19: Neuromuscular and mechanical disorders of the small bowel

Intussusception

Internal (intra‐abdominal) hernia

Volvulus

Perforation and rupture

Small‐intestinal obstruction

Neurological disorders

References

CHAPTER 20: Inflammatory disorders of the small intestine

Introduction

Inflammation due to identifiable micro‐organisms

Inflammatory bowel disease

Drug‐induced enteropathy

Miscellaneous inflammatory conditions of the small intestine

References

CHAPTER 21: The pathology of malnutrition and malabsorption

Introduction

Malnutrition due to an unsatisfactory diet

Malnutrition consequent on maldigestion

Malnutrition due to malabsorption

References

CHAPTER 22: Vascular disorders of the small intestine

Introduction

Vascular anatomy and physiology of the small intestine

Telangiectasia

Angiodysplasia

Arteriovenous malformation

Hereditary haemorrhagic telangiectasia

Blue rubber bleb nevus syndrome

Ehlers–Danlos syndrome, vascular type (Type IV)

Ischemic enteritis

References

CHAPTER 23: Polyps and tumour‐like lesions of the small intestine

Sporadic small‐intestinal adenomas

Adenomas in familial adenomatous polyposis

Peutz–Jeghers polyps

Juvenile polyps

Cronkhite–Canada syndrome

Brunner’s gland hyperplasia and hamartoma

Peri‐ampullary myo‐epithelial hamartoma/adenomyoma

Pyogenic granuloma

References

CHAPTER 24: Malignant epithelial tumours of the small intestine

Introduction

Adenocarcinoma

Neuroendocrine cell neoplasms

Metastatic epithelial tumours

References

CHAPTER 25: Mesenchymal tumours of the small intestine

Introduction

Gastrointestinal stromal tumours

Smooth‐muscle tumours of the small intestine

Mesenteric fibromatosis

Sclerosing mesenteritis

Inflammatory myofibroblastic tumour and epithelioid inflammatory myofibroblastic sarcoma

IgG4‐related fibrosclerosing disease

Calcifying fibrous pseudo‐tumour

Tumours of adipose tissue

Vascular tumours

Neural tumours of the small intestine

Inflammatory fibroid polyp of the small intestine

Translocation sarcomas involving the small intestine

References

CHAPTER 26: Lymphoid tumours of the small intestine

Normal lymphoid components of the small intestine

Reactive lymphoid hyperplasia

Primary non‐Hodgkin lymphomas of the small intestine

Secondary lymphomatous involvement of the small intestine

Myeloid malignancies involving the small intestine

References

CHAPTER 27: Miscellaneous disorders of the small intestine

Amyloidosis

Bypass operations

Cholesterol ester storage Whipple’s

Endometriosis

Pneumatosis cystoides intestinalis

Malakoplakia

Systemic mastocytosis

Melanosis and pseudo‐melanosis

Zinc deficiency

Pseudo‐lipomatosis

Graft‐versus‐host disease

Small‐intestinal transplantation

References

PART 4: Appendix

CHAPTER 28: Normal appendix: anatomy, specimen dissection and histology relevant to pathological practice

Anatomy

Histology

Specimen dissection

References

CHAPTER 29: Inflammatory disorders of the appendix

Introduction

Unusual findings unique to the appendix

Acute appendicitis

Chronic appendicitis

Infectious causes of appendicitis

Fungal infection

References

CHAPTER 30: Tumours of the appendix

Low‐grade appendiceal mucinous neoplasms

Adenocarcinoma

Serrated polyps and hyperplastic lesions

Colonic‐type adenomas

Neuroendocrine neoplasms

Tubular neuroendocrine tumours

Goblet‐cell adenocarcinoma

Mesenchymal tumours

Neural lesions

Malignant lymphoma

Secondary tumours

References

CHAPTER 31: Miscellaneous conditions of the appendix

Normal embryology and foetal development

Developmental abnormalities

Acquired diverticula

Appendiceal diverticulitis

Intussusception

Torsion

Endometriosis and conditions related to pregnancy

Cystic fibrosis

Foreign bodies

Melanosis

References

PART 5: Large Intestine

CHAPTER 32: Normal large intestine: anatomy, specimen dissection and histology relevant to pathological practice

Anatomy

Anatomy of the rectum

Cross‐sectional anatomy of the large intestine

Blood supply and drainage

Lymphatic drainage

Nerve supply

Specimen handling

Histology

The colorectal microbiome

References

CHAPTER 33: Embryogenesis and developmental abnormalities (including the anal region)

Normal development

Malpositions

Vestigial remnants

Maldevelopments

Disturbances of innervation

Hirschsprung’s disease

Allied Hirschsprung’s disorders

References

CHAPTER 34: Muscular and mechanical disorders of the large intestine

Diverticular disease of the colon

Diverticulosis of the right colon

Irritable bowel syndrome

Idiopathic constipation, megacolon, megarectum and pseudo‐obstruction

Megacolon and megarectum

Volvulus

Mucosal prolapse and solitary ulcer syndrome

Intussusception and complete rectal prolapse

Trauma

Foreign bodies

References

CHAPTER 35: Inflammatory disorders of the large intestine

Introduction

Infection

Viral infection

Bacterial infection

Fungi

Parasites

Inflammatory bowel disease

Sarcoidosis

Cord colitis syndrome

Drugs and colorectal disease

Focal active colitis

Radiation

Diversion proctocolitis

Necrotising enterocolitis / neonatal necrotising enterocolitis

Neutropaenic colitis / neutropaenic enterocolitis

Phlegmonous colitis

Microscopic colitis

Mast cell disorders

Obstructive colitis

Behçet’s disease

Langerhans cell histiocytosis of the lower GI tract

Eosinophilic gastroenterocolitis

Common variable immune deficiency

IgA deficiency

Chronic granulomatous disease

Immune dysfunction, polyendocrinopathy, enteropathy, X‐linked

Wiskott–Aldrich Syndrome

IgA vasculitis

IgG4‐related disease

Rosai–Dorfman disease of the lower GI tract

Pneumatosis coli / pneumatosis intestinalis

Brown bowel syndrome

Final comment

References

CHAPTER 36: Vascular disorders of the large intestine

Anatomy

Large‐intestinal ischaemia

Vascular lesions of the large intestine

Enterocolic phlebitis

Idiopathic myointimal hyperplasia of mesenteric veins

References

CHAPTER 37: Polyps, polyposis syndromes and tumour‐like lesions of the large intestine

Conventional adenoma

Adenoma involving lymphoglandular complexes

Adenocarcinoma arising in an adenoma (‘malignant colorectal polyp’)

Serrated polyp/lesion

Adenomatous polyposis syndromes

Hamartomatous polyps and polyposis syndromes

Serrated polyposis

Inflammatory polyps

Other polyps

References

CHAPTER 38: Malignant epithelial neoplasms of the large intestine

Introduction

Epidemiology

Aetiology

Pathogenesis of colorectal neoplasia

The molecular classification of colorectal carcinoma

Macroscopic pathology of colorectal carcinoma

Microscopic pathology of colorectal carcinoma

Assessment of response to therapy

Synchronous colorectal cancers

Colorectal carcinoma in patients with inflammatory bowel disease

Spread of colorectal cancer

Immunohistochemical markers of colorectal carcinoma

Pathological staging of colorectal cancer

The concept of intramucosal carcinoma in the colorectum

Prognostic indicators in colorectal cancer

Pathological considerations in localised resections for colorectal cancer

Neuroendocrine tumours

Rare forms of colorectal cancer

Datasets and reporting standards

Screening for colorectal cancer

References

CHAPTER 39: Mesenchymal tumours of the large intestine

Introduction

Gastrointestinal stromal tumours

Smooth‐muscle tumours

Tumours of adipose tissue

Vascular tumours

Neurogenic tumours

Fibroblastic and myofibroblastic tumours

Tumours of uncertain differentiation

References

CHAPTER 40: Lymphoid tumours of the large intestine

Normal lymphoid components of the large intestine

Reactive lymphoid lesions

Primary lymphomas of the large intestine

EBV‐positive mucocutaneous ulcer

Lymphoproliferative disorders in patients with inflammatory bowel disease

Secondary involvement of the large intestine by haematological malignancies

References

CHAPTER 41: Miscellaneous disorders of the large intestine

Amyloid

Endometriosis

Melanosis coli

Muciphages

Pneumatosis coli

Pseudo‐lipomatosis

Stercoral ulceration

Graft‐versus‐host disease

Cord colitis syndrome

Effects of bowel preparation

Torsion of appendixes epiploicae

Barium granuloma

Malakoplakia

Squamous metaplasia of the colorectum

References

PART 6: The Anus

CHAPTER 42: Normal anal region: anatomy, histology relevant to pathology practice and specimen handling

Anatomy

Histology

Specimen handling

References

CHAPTER 43: Inflammatory disorders of the anal region

Miscellaneous inflammatory conditions

Infectious disease of the anorectum

Inflammatory bowel disease involving the anorectum

References

CHAPTER 44: Tumours and tumour‐like conditions of the anus

Benign epithelial tumours and pre‐cancerous lesions of the anal canal and perianal skin

Malignant tumours of the anal canal

Malignant tumours of perianal skin

Miscellaneous tumours

References

CHAPTER 45: Miscellaneous conditions of the anal region

Haemorrhoids

Oleogranuloma

Ectopic tissue

Anal incontinence

References

PART 7: Peritoneum

CHAPTER 46: The normal peritoneum: anatomy and histology

Anatomy

Histology

References

CHAPTER 47: Inflammatory disorders of the peritoneum

Acute diffuse peritonitis

Special forms of peritonitis

Sclerosing mesenteritis

Fat necrosis after pancreatitis

References

CHAPTER 48: Tumours and tumour‐like lesions of the peritoneum

Introduction

Mesothelial hyperplasia

Mesothelial neoplasia

Epithelial tumours of the peritoneum

Metaplastic tumour‐like lesions of the peritoneum

Primary tumours arising from the subserosal mesenchyme

Tumours of uncommitted stem cells or uncertain histogenesis

Tumour‐like conditions of the peritoneum

Secondary tumours

References

CHAPTER 49: Miscellaneous conditions of the peritoneum

Ascites

Pneumoperitoneum

Intraperitoneal loose bodies

Torsion and segmental infarction of the greater omentum

Splenosis

Trophoblastic implants

Cartilaginous metaplasia

References

Index

End User License Agreement

List of Tables

Chapter 4

Table 4.1 Summary and comparison of clinicopathologic features in GORD and ...

Chapter 5

Table 5.1 A suggested reporting strategy for biopsies from Barrett’s oesoph...

Table 5.2 The Vienna classification, now universally recommended for use in...

Table 5.3 Useful pathological criteria for the diagnosis of low grade and h...

Table 5.4 Cytological and architectural features of low and high grade dysp...

Table 5.5 Common causes for error in the pathological diagnosis of dysplasi...

Chapter 6

Table 6.1 Classification of polyps of the oesophagus

Chapter 7

Table 7.1 Predisposing risk factors for oesophageal squamous‐cell carcinoma...

Table 7.2 TNM staging of oesophageal carcinoma

Chapter 9

Table 9.1 Practical immunohistochemical markers for epithelial cell lineage...

Table 9.2 Major endocrine cells in the gastric mucosa

Table 9.3 Summary of recommended sections of gastric neoplasia

Chapter 11

Table 11.1 Differential diagnoses of gastritis

Table 11.2 Diseases associated with

H. pylori

infection

Table 11.3 Comparison of

H. pylori

detection methods in biopsy tissue

Table 11.4 Comparison of

H. pylori

and

H. heilmannii

Table 11.5 Risk factors for peptic ulceration

Table 11.6 Gastric mucosal defence mechanisms

Table 11.7 Complications of gastric peptic ulceration

Table 11.8 Classification of ECL‐cell hyperplasia

Table 11.9 Comparison of

H. pylori

and AIG

Table 11.10 Causes of gastric mucosal eosinophil infiltration

Table 11.11 Causes of increased gastric IELs

Table 11.12 Causes of gastric granulomatous and histiocytic inflammation

Table 11.13 Grading of acute GVHD of the stomach

Table 11.14 Comparison of GAVE with other gastropathies

Table 11.15 Opportunistic gastric infections in AIDS

Chapter 12

Table 12.1 Classification of gastric polyps

Table 12.2 Summary of characteristics of FGPs

Table 12.3 Risk factors for development of hyperplastic polyps

Table 12.4 Hyperplastic polyp variants and associated lesions

Table 12.5 Gastric type adenomas: subtypes and characteristics

Table 12.6 Features of hamartomatous polyposis syndromes and similar condit...

Table 12.7 Diagnostic criteria for juvenile polyposis

Table 12.8 Diagnostic criteria for Peutz–Jeghers syndrome

Chapter 13

Table 13.1 The Vienna classification of gastrointestinal epithelial neoplas...

Table 13.2 Morphologic differences of gastric dysplasia/intra‐epithelial ne...

Table 13.3 Management of patients with gastric dysplasia/intra‐epithelial n...

Table 13.4 Comparison of the most commonly used classifications of the epit...

Table 13.5 TNM classification of tumours of the stomach [237]

Table 13.6 Five‐year survival of gastric cancer [modified from 433]

Table 13.7 Gastric manifestations of familial cancer predisposition syndrom...

Table 13.8 2020 Hereditary diffuse gastric cancer genetic testing criteria....

Table 13.9 Frequency of the most common genetic alterations found in gastri...

Table 13.10 Scoring system to evaluate

HER2

IHC testing

Table 13.11 Molecular classification schemes of gastric cancer

Table 13.12 Clinicopathological features of gastric NETs. Adapted from [577...

Table 13.13 Classification and grading of gastric neuroendocrine neoplasms...

Chapter 14

Table 14.1 Miettinen criteria for risk assessment of primary gastric GI str...

Chapter 15

Table 15.1 Primary histological types of primary gastric lymphoma

Table 15.2 Staging systems for gastric lymphoma

Table 15.3 Investigative procedures at diagnosis for gastric lymphoma

Table 15.4 Practical recommendations for the diagnosis and follow‐up of gas...

Table 15.5 Wotherspoon scoring system for gastric lymphoid infiltrates

Table 15.6 GELA histological grading system for post‐treatment assessment o...

Chapter 17

Table 17.1 Epithelial cells of the small intestine and their principal func...

Chapter 18

Table 18.1 Small‐bowel malformations as part of other diseases or syndromes...

Table 18.2 Clinical emergencies due to congenital small‐bowel abnormalities...

Chapter 19

Table 19.1 Approach to a dysmotility specimen

Table 19.2 Small bowel intussusception

Table 19.3 Mechanical causes of small‐intestinal obstruction

Table 19.4 Causes of chronic small intestinal pseudo‐obstruction

Chapter 20

Table 20.1 Distinguishing features of granulomas

Table 20.2 Summary of major causes of drug‐related enteric lesions

Chapter 21

Table 21.1 Classification and causes of malnutrition and malabsorption

Table 21.2 Grading of gluten‐induced enteropathy: modified Oberhuber–Marsh ...

Table 21.3 Villanacci–Corazza classification scheme

Table 21.4 Ensari classification

Table 21.5 Causes/associations of lymphocytic duodenitis in recent studies...

Table 21.6 Causes of intra‐epithelial lymphocytosis with normal architectur...

Table 21.7 Causes of villous flattening with and without intra‐epithelial l...

Table 21.8 Clues to the differential diagnosis of a coeliac disease like en...

Table 21.9 Differentiation of RCD‐1 and RCD‐2

Chapter 22

Table 22.1 Distinguishing features of non‐neoplastic vascular lesions of th...

Table 22.2 Curacao criteria for a diagnosis of hereditary haemorrhagic tela...

Table 22.3 Criteria and diagnostic features for a diagnosis of vascular Ehl...

Table 22.4 International clinical criteria for Behcet’s disease

Chapter 23

Table 23.1 Staging system for severity of duodenal polyposis in familial ad...

Chapter 24

Table 24.1 WHO classification of small‐intestinal carcinoma

Table 24.2 Histological grading system for adenocarcinomas based on the ext...

Table 24.3 TNM descriptors

Table 24.4 Pathologic stage classification (pTNM, AJCC 8th Edition) of smal...

Table 24.5 WHO classification of carcinomas of the ampulla of Vater

Table 24.6 Immunohistochemical profile of adenocarcinomas of the ampulla of...

Table 24.7 Pathological stage classification (pTNM, AJCC 8th Edition) of ca...

Table 24.8 Recommended grading system for well‐differentiated gastroenterop...

Table 24.9 Pathological stage classification (pTNM, AJCC 8th Edition) of ne...

Table 24.10 Pathological stage classification (pTNM, AJCC 8th Edition) of n...

Table 24.11 Types of MiNENs of the digestive system grouped to the grade of...

Chapter 25

Table 25.1 Risk assessment in small‐intestinal GISTs

Table 25.2 Intestinal gastrointestinal stromal tumours: key mutations

Table 25.3 Inflammatory cell‐rich mesenteric lesions of small bowel

Chapter 26

Table 26.1 Main histological types of primary lymphomas of the small intest...

Table 26.2 Aggressive B‐cell lymphomas involving the small intestine

Table 26.3 Distinctive pathological features of small B‐cell lymphomas invo...

Table 26.4 Pathological and genetic features of EATL and MEITL

Chapter 28

Table 28.1 Principal histological differences between appendix and colon

Chapter 29

Table 29.1 Distinction between inflammatory appendiceal changes and low‐gra...

Table 29.2 Differential diagnosis of granulomatous appendicitis

Chapter 30

Table 30.1 Grading of neuroendocrine tumours according to the WHO 2019 clas...

Table 30.2 Features of appendiceal NETs according to histological type

Table 30.3 Appendiceal NET staging classification for local spread of the p...

Table 30.4 WHO grading of goblet‐cell adenocarcinoma, 2019 edition

Chapter 31

Table 31.1 Modified Cave–Wallbridge classification

Table 31.2 Classification of caecal and appendiceal developmental anomalies...

Table 31.3 Classification of appendiceal intussusception

Chapter 33

Table 33.1 Anorectal anomalies: a suggested international classification

Table 33.2 The Krickenbeck classification of anorectal malformations (ARMs)...

Table 33.3 RCPath guidance for handling specimens in possible Hirschsprung’...

Chapter 34

Table 34.1 Terminology related to diverticular disease

Table 34.2 Key statistics in diverticular disease

Table 34.3 Complications of diverticular disease

Table 34.4 Differential diagnoses

Table 34.5 Overview of clinical types of constipation

Table 34.6 Causes of chronic colonic pseudo‐obstruction and megacolon

Table 34.7 Prevalence of sigmoid volvulus as a cause of large bowel obstruc...

Chapter 35

Table 35.1 Colorectal involvement in HIV

Table 35.2 LGV/syphilis versus IBD

Table 35.3 Examples of genes implicated in the pathogenesis of IBD

Table 35.4 IBD: clinical features

Table 35.5 Discontinuity in UC

Table 35.6 Pathology of UC and Crohn’s disease in colorectal resections: su...

Table 35.7 Crohn’s‐like features that can occur in UC resections

Table 35.8 Superficial Crohn’s colitis / UC‐like Crohn’s disease

Table 35.9 Role of biopsy in IBD

Table 35.10 New presentation of IBD: distribution of histological abnormali...

Table 35.11 Histological features that may be present in colorectal biopsie...

Table 35.12 Definitions of histological features that occur in IBD

Table 35.13 Features that distinguish IBD from non‐IBD in initial colorecta...

Table 35.14 Summary of Nancy histological index for grading inflammation in...

Table 35.15 Simple scheme for grading of activity of IBD in clinical practi...

Table 35.16 Features favouring infective colitis over IBD

Table 35.17 Features favouring UC over Crohn’s disease in initial biopsies...

Table 35.18 Features favouring Crohn’s disease over UC in initial biopsies...

Table 35.19 Duration of symptoms versus frequency of discriminant histologi...

Table 35.20 Unhelpful or uninformative terminology when reporting colorecta...

Table 35.21 Dysplasia in the large‐bowel mucosa

Table 35.22 A comparison between diverticular colitis and IBD

Table 35.23 Comparison of prevalence of histological patterns of injury as ...

Table 35.24 Features of ipilimumab colitis compared to UC

Table 35.25 Atypical non‐neoplastic cells in radiation damage to the GI tra...

Table 35.26 Chronic radiation damage to the colorectum: differential diagno...

Table 35.27 Comparison of lymphocytic colitis with collagenous colitis

Table 35.28 Comparison of new IBD and microscopic colitis

Table 35.29 Eosinophil counts in normal lower GI tract mucosa

Chapter 36

Table 36.1 Features of ischaemic colitis on biopsy

Chapter 37

Table 37.1 Classification of colorectal polyps

Table 37.2 The Paris endoscopic classification of superficial GI neoplastic...

Table 37.3 The Kudo and NICE classifications for optical prediction of colo...

Table 37.4 Variant cells found in adenomas

Table 37.5 Benign changes in adenomas that mimic invasive adenocarcinoma

Table 37.6 Comparison of features of epithelial misplacement into the submu...

Table 37.7 Features to include in the histological report for malignant col...

Table 37.8 Haggitt levels of invasion in malignant pedunculated adenomas an...

Table 37.9 Different depths of submucosal invasion in malignant adenomas fo...

Table 37.10 Clinical and molecular features of serrated polyps

Table 37.11 Clinicopathological features of MVHP versus SSL

Table 37.12 The most common genetic polyposis syndromes involving the GI tr...

Table 37.13 Genotype‐phenotype correlations in FAP

Table 37.14 Extra‐colonic manifestations in classic FAP

Table 37.15 Clinical context associated with juvenile polyps

Table 37.16 Differential diagnosis of colorectal juvenile polyp

Table 37.17 Cancer risks at 65–70 years by organ in Peutz–Jeghers syndrome...

Table 37.18 Lifetime cancer risks in Cowden syndrome

Chapter 38

Table 38.1 Proposed environment–gene interactions

Table 38.2 Pathways to colorectal carcinoma

Table 38.3 Molecular genetic classification of colorectal carcinoma

Table 38.4 Summary of the most common ‘standard’ surgical resections for CR...

Table 38.5 Staging of CRC: comparison of TNM and Dukes staging

Chapter 39

Table 39.1 Polyps of neurogenic origin in the large intestine

Chapter 41

Table 41.1 The main clinical effects of amyloidosis

Table 41.2 The main systemic forms of amyloid

Table 41.3 Associations with melanosis coli

Table 41.4 Mucosal accumulations in the colorectum

Chapter 44

Table 44.1 Microscopic features of differentiated perianal squamous intra‐e...

Table 44.2 Established risk factors for anal canal squamous cell carcinoma...

Table 44.3 Morphological features which help distinguish between basal cell...

Chapter 47

Table 47.1 Potential causes of acute peritonitis, typically associated with...

Chapter 48

Table 48.1 Classification of primary peritoneal tumours

Table 48.2 Histological features distinguishing reactive mesothelial prolif...

Table 48.3 Histological patterns seen in epithelioid malignant mesothelioma...

Table 48.4 Antibodies useful in the differential diagnosis of peritoneal me...

Table 48.5 Histological classification of pseudomyxoma peritonei

List of Illustrations

Chapter 1

Figure 1.1 The wall of the oesophagus. In this cross‐section, A is the squam...

Figure 1.2 The normal stratified squamous epithelium of the oesophagus. It h...

Figure 1.3 Ki‐67 immunostaining of the normal oesophageal mucosa. The basal ...

Figure 1.4 The submucosal gland of the oesophagus. The terminal portions con...

Figure 1.5 A schema of the palisade veins in the lower oesophageal sphincter...

Figure 1.6 An endoscopic image of the middle and lower oesophagus. A mesh‐li...

Figure 1.7 Histology of the lower oesophagus lined by squamous epithelium. (...

Figure 1.8 Histology of the lower oesophagus lined with columnar epithelium....

Figure 1.9 The oesophageal cardiac glands (also known as superficial or muco...

Figure 1.10 Pancreatic metaplasia and ciliated epithelium in the mucosa at t...

Chapter 2

Figure 2.1 (a) The wall of an oesophageal duplication cyst. The wall is line...

Figure 2.2 Macroscopic appearance of an oesophago‐bronchogenic cyst. The res...

Figure 2.3 (a) Histology of part of the bronchogenic cyst from the oesophago...

Figure 2.4 (a) Macroscopic appearance of oesophageal atresia and tracheo‐oes...

Figure 2.5 Heterotopic gastric mucosa in the upper oesophagus. Fundic‐type g...

Figure 2.6 Macroscopic appearance of heterotopic sebaceous glands. Sebaceous...

Figure 2.7 Sebaceous glands in the lamina propria lie beneath the oesophagea...

Chapter 3

Figure 3.1 (a) Representative picture from the distal oesophagus of a sclero...

Figure 3.2 Barium swallow of patient with achalasia showing the ‘bird‐beak’ ...

Chapter 4

Figure 4.1 Reflux changes. (a) There is thickening of the basal‐cell layer o...

Figure 4.2 (a) Multiple discrete ulcers of variable sizes are present in her...

Figure 4.3 (a) Innumerable CMV inclusions are seen within the endothelial ce...

Figure 4.4 (a) Yellow plaques overlying ulcerated mucosa are seen in this gr...

Figure 4.5 A caseating granuloma indicating oesophageal involvement by

M. tu

...

Figure 4.6 Bacterial oesophagitis, featuring clusters of bacteria present wi...

Figure 4.7 Mega‐oesophagus due to Chagas disease.

Figure 4.8 Eosinophilic oesophagitis. (a) Spongiosis and numerous eosinophil...

Figure 4.9 Drug‐induced or pill oesophagitis. (a) Complete mucosal denudatio...

Figure 4.10 Sloughing oesophagitis featuring superficial eosinophilic mucosa...

Figure 4.11 The lymphocytic pattern of features an exclusively lymphocytic i...

Figure 4.12 Lichen planus of the oesophagus, featuring a band‐like lymphocyt...

Chapter 5

Figure 5.1 A definitive diagnosis of CLO can be made from this biopsy specim...

Figure 5.2 Typical CLO mucosa seen in a biopsy. There is intestinal‐type epi...

Figure 5.3 This biopsy shows CLO with a patchwork of glands with cardiac, fu...

Figure 5.4 Extensive surface multi‐layered epithelium overlies cardiac‐type ...

Figure 5.5 This biopsy of Barrett’s oesophagus demonstrates extensive contin...

Figure 5.6 Low grade dysplasia in CLO. The sharp cut‐offs between non‐neopla...

Figure 5.7 High grade dysplasia in CLO. There are notable cytological abnorm...

Figure 5.8 Low grade dysplasia in an EMR specimen. Such specimens generally ...

Figure 5.9 An EMR undertaken for neoplasia complicating CLO. Glandular mucos...

Figure 5.10 Extensive squamous re‐epithelialisation as a result of ablation ...

Figure 5.11 Squamous re‐epithelialisation in high grade dysplastic CLO. That...

Chapter 6

Figure 6.1 Inflammatory/hyperplastic polyp. (a) The polyp has a smooth surfa...

Figure 6.2 Giant fibrovascular polyp. (a) Longitudinal section through a sau...

Figure 6.3 Atypical lipomatous tumour (well‐differentiated liposarcoma). (a)...

Figure 6.4 (a) Glycogenic acanthosis with hyperplastic squamous epithelium w...

Figure 6.5 Squamous papilloma. (a) Verruciform or warty topography with squa...

Chapter 7

Figure 7.1 Warthin’s tumour of the oesophagus. It involves the submucosal gl...

Figure 7.2 Pleomorphic adenoma of the oesophagus. Glandular structures lined...

Figure 7.3 Squamous dysplasia, high grade: full‐thickness involvement of epi...

Figure 7.4 An ill‐defined, multinodular, gray early squamous cell carcinoma ...

Figure 7.7 A nodular and ulcerated SCC involving the upper oesophagus. Multi...

Figure 7.8 Well‐differentiated SCC with keratinisation.

Figure 7.9 Poorly differentiated SCC. A tumour is seen infiltrating below th...

Figure 7.10 Verrucous carcinoma: well‐differentiated SCC with surface matura...

Figure 7.11 Carcinosarcoma. A large, lobulated polypoid growth is present at...

Figure 7.12 Spindle‐cell carcinoma (carcinosarcoma): foci of poorly differen...

Figure 7.13 Basaloid–squamous carcinoma. Lobules of basaloid cells with a fe...

Figure 7.14 (a) Basaloid carcinoma with microcystic architecture and basemen...

Figure 7.15 Ulcerated adenocarcinoma arising in columnar‐lined oesophagus.

Figure 7.16 This oesophagectomy specimen shows the upper part lined by squam...

Figure 7.17 Residual tumour may not be grossly visible in resections perform...

Figure 7.18 OACs may show a (a) tubular, (b) papillary or (c) solid architec...

Figure 7.19 Adenocarcinoma infiltrating the oesophageal wall. Note the high‐...

Figure 7.20 Common molecular alterations in squamous‐cell carcinoma and aden...

Figure 7.21 Adenosquamous carcinoma with two distinct components. (a) A glan...

Figure 7.22 Adenoid cystic carcinoma of the oesophagus. (a) Cribriform nests...

Figure 7.23 (a) Small‐cell carcinoma showing focal crush artefact is present...

Figure 7.24 (a) Undifferentiated epithelial tumour with scattered uni‐ and m...

Figure 7.25

SMARCA4

‐deficient undifferentiated oesophageal carcinoma arising...

Figure 7.26 Malignant melanoma: a protuberant, superficially ulcerated, pigm...

Figure 7.27 Sheets of undifferentiated tumour cells with evenly dispersed ch...

Figure 7.28 Granular cell tumours are located in the submucosa (a) and show ...

Figure 7.29 Atypical lipomatous tumour of the oesophagus. (a) A slender, fin...

Figure 7.30 Undifferentiated spindle‐cell sarcoma in a patient treated with ...

Figure 7.31 An unusual example of metastatic papillary thyroid carcinoma inv...

Figure 7.32 (a) Primary oesophageal plasmablastic lymphomas occur in HIV‐pos...

Chapter 8

Figure 8.1 Gastric inlet patch in upper oesophagus showing a combination of ...

Figure 8.2 Post‐mortem image showing black oesophagus starting abruptly at t...

Figure 8.3 Barium swallow of a patient with rings (small and large arrows) o...

Chapter 9

Figure 9.1 Gross appearance of the gastric mucosal surface of a 4‐month‐old ...

Figure 9.2 View of the layered structure of the gastric wall (same case as F...

Figure 9.3 Surface (foveolar) epithelium covering the surface and pits of no...

Figure 9.4 Full‐thickness view of the body mucosa. The fundic glands consist...

Figure 9.5 Fundic gland mucosa. (a) The neck region is composed of mucous ne...

Figure 9.6 (a) Full‐thickness view of the antral mucosa. (a) The pyloric gla...

Figure 9.7 (a) Cardiac mucosa, similar in morphology to the mucosa of the an...

Figure 9.8 Metaplasia of the gastric mucosa. (a) Pseudo‐pyloric gland metapl...

Figure 9.9 Immunohistochemistry of fundic gland mucosa. (a) MUC5AC stains th...

Figure 9.10 Endocrine cells in the gastric mucosa. (a) Gastrin‐producing G c...

Figure 9.11 Proliferating cells in the gastric mucosa demonstrated by immuno...

Figure 9.12 Illustration of the three‐layer muscle coat of the stomach (the ...

Figure 9.13 Interstitial cells of Cajal in the muscularis propria revealed b...

Figure 9.14 Two arterial supply loops of the stomach, which stem the celiac ...

Figure 9.15 Mucosal lymphatics revealed by D2‐40 (podoplanin) immunostaining...

Figure 9.16 On magnifying endoscopy with narrow‐band imaging, (a) the body m...

Figure 9.17 Dissection of gastric specimens. (a) Distal gastrectomy specimen...

Chapter 10

Figure 10.1 Abdominal sonographic examination demonstrating a thickened hype...

Figure 10.2 Endoscopic ultrasound appearance of cystic‐type gastric duplicat...

Figure 10.3 Three‐year‐old girl with dextrogastria. Shown here are symmetric...

Figure 10.4 Heterotopic pancreas. Gastric biopsy specimen shows gastric muco...

Figure 10.5 Heterotopic pancreas, ‘adenomyoma’ variant. (a) This lesion is c...

Figure 10.6 Submucosal heterotopic gastric glands. (a) In this example, the ...

Chapter 11

Figure 11.1 Global prevalence of

H. pylori

infection.

Figure 11.2 Characteristic histology of

H. pylori

chronic active gastritis. ...

Figure 11.3 Degenerative changes in gastric surface epithelial cells in

H. p

...

Figure 11.4 Severe

H. pylori

pangastritis affecting corpus/fundic mucosa and...

Figure 11.5 (a) Initial antral biopsy in

H. pylori

‐associated chronic follic...

Figure 11.6 (a) Abundant

H. pylori

organisms are readily identified on a rou...

Figure 11.7

H. heilmannii

organisms on gastric biopsy. The bacteria are long...

Figure 11.8 Histology of gastric erosion showing necrotic debris and fibrin ...

Figure 11.9 Acute erosive gastritis showing multiple erosions with mucosal h...

Figure 11.10 A chronic peptic ulcer on the lower part of the lesser curvatur...

Figure 11.11 A whole‐mount section of a chronic gastric peptic ulcer showing...

Figure 11.12 A gastric ulcer was resected after severe haemorrhage. An erode...

Figure 11.13 Gastric atrophy with extensive complete (type I) IM, including ...

Figure 11.14 Type IIb IM with (a) sulphomucin (brown) mainly in columnar cel...

Figure 11.15 (a) Gastric corpus in late AIG. There is severe atrophy with to...

Figure 11.16 Late stage of AIG. (a) Severely atrophic corpus mucosa with ext...

Figure 11.17 Syphilitic gastritis. (a) Dense lymphoplasmacytic mucosal infil...

Figure 11.18 EBV‐associated gastritis. (a) Dense lamina propria polymorphic ...

Figure 11.19 Lymphomatoid gastropathy. (a) Medium‐sized to large atypical ly...

Figure 11.20 Primary eosinophilic gastritis. (a) Note the prominent lamina p...

Figure 11.21 Acute suppurative/phlegmonous gastritis. (a) Prominent lamina p...

Figure 11.22 Doxycycline‐induced gastritis demonstrating (a) intense neutrop...

Figure 11.23 Collagenous gastritis. The diagnostic sub‐epithelial collagen b...

Figure 11.24 Lymphocytic gastritis. (a) Low‐power view showing increased chr...

Figure 11.25 Gastric manifestations of Crohn’s disease. (a) Granulomatous ga...

Figure 11.26 Foreign‐body granuloma in relation to a gastric ulcer. Note the...

Figure 11.27 Gastric tuberculosis. (a) Numerous large mucosal granulomas wit...

Figure 11.28 Gastric strongyloidiasis hyperinfection showing (a) large adult...

Figure 11.29 Post‐treatment gastric schistosomiasis. (a) Ova in the deep muc...

Figure 11.30 (a) Zygomycete organisms in the necrotic debris of a gastric ul...

Figure 11.31 (a) Gastric xanthoma presenting as a mucosal polyp containing s...

Figure 11.32 CMV infection in an immunocompromised HIV patient. (a) Numerous...

Figure 11.33 VZV gastritis. (a) Necrosis and ulceration with adjacent intact...

Figure 11.34 Reactive gastropathy. (a) Biopsies appear blue on low‐power due...

Figure 11.35 Moderate to severe acute gastric GVHD. (a) Pronounced epithelia...

Figure 11.36 Paraneoplastic gastric GVHD‐like changes associated with thymom...

Figure 11.37 Drug‐induced gastritis associated with (a) colchicine and (b) t...

Figure 11.38 Chemotherapy‐induced gastritis in a patient on a multi‐drug pro...

Figure 11.39 Radiation gastritis in a patient treated for gastro‐oesophageal...

Figure 11.40 Gastric antral vascular ectasia (GAVE). (a) The lesion is chara...

Figure 11.41 Iron‐pill gastritis. (a) Crystalline iron in the gastric lamina...

Figure 11.42 Gastric mucosal calcinosis. Deposits of cyanophilic crystals en...

Figure 11.43 Typical rhomboid and triangular basophilic kayexalate crystals ...

Figure 11.44 Gastric ulcer demonstrating basophilic Yttrium‐90 microspheres,...

Figure 11.45 Gastric cryptosporidiosis in an HIV patient. Multiple small bas...

Figure 11.46 Gastric toxoplasmosis showing glandular cysts with abundant bra...

Figure 11.47

Emergomyces africanus

gastritis in advanced HIV, showing (a) pr...

Figure 11.48 Sickle‐shaped

Giardia intestinalis

trophozoites, an unusual gas...

Figure 11.49

Sarcina ventriculi

in a patient with pyloric ulceration.

Chapter 12

Figure 12.1 Fundic gland polyp. (a) low‐power view showing characteristic cy...

Figure 12.2 Polyp in a GAPPS patient. (a)The low‐power view shows superficia...

Figure 12.3 (a) Fundic gland polyp with dysplastic transformation involving ...

Figure 12.4 Hyperplastic polyp composed of elongated and distorted foveolae ...

Figure 12.5 Hyperplastic polyp: higher‐power view of elongated and branching...

Figure 12.6 Inflamed and eroded hyperplastic polyp. (a) Severe stroma inflam...

Figure 12.7 Polypoid foveolar hyperplasia. This small lesion measuring about...

Figure 12.8 Gastritis cystica polyposa. (a) This dome‐shaped lesion is forme...

Figure 12.9 Gastric prolapse polyp. This lesion is characterised by thickene...

Figure 12.10 (a) Hyperplastic polyp with dysplastic transformation involving...

Figure 12.11 Intestinal type dysplasia, low grade. (a) The lesion maintains ...

Figure 12.12 Intestinal type dysplasia, high grade. (a) Compared to Figure 1...

Figure 12.13 Foveolar type dysplasia, low grade. (a) The lesion presents min...

Figure 12.14 Foveolar type dysplasia, high grade. In this example, the lesio...

Figure 12.15 Pyloric gland adenoma (low‐grade dysplasia). (a) The polyp comp...

Figure 12.16 Pyloric gland adenoma with high‐grade dysplasia. (a) The tubule...

Figure 12.17 Oxyntic gland adenoma. (a) In this example, the cells are arran...

Figure 12.18 Juvenile polyp. (a) The lesion comprises cystically dilated gla...

Figure 12.19 Juvenile polyp with neoplastic transformation. The polyp mainta...

Figure 12.20 Peutz–Jeghers polyp. The lesion is characterised by thin dissec...

Figure 12.21 Cowden syndrome polyp. This example shows elongation of the fov...

Figure 12.22 Cronkhite–Canada polyp. This characteristic polyp displays fove...

Figure 12.23 Inflammatory fibroid polyp. (a) The lesion appears as a cellula...

Figure 12.24 Gastric lipoma. Benign adipocytes extend through the submucosa ...

Figure 12.25 Gastric xanthoma. (a) The lesion is composed of loosely packed ...

Figure 12.26 Pancreatic heterotopia. (a) The polypoid lesion is formed by ac...

Figure 12.27 Ménétrier disease. The mucosa shows marked thickening of the ga...

Figure 12.28 Ménétrier disease. (a) Low‐power view demonstrates extended gas...

Chapter 13

Figure 13.1 Two cases originally sent in for consultation with a diagnosis o...

Figure 13.2 Endoscopic appearance of gastric dysplasia: the contour of the r...

Figure 13.3 Low‐grade dysplasia (adenomatous type). (a) There is limited arc...

Figure 13.4 Example of foveolar type dysplasia. (a) This low‐grade lesion is...

Figure 13.5 Pyloric type dysplasia (pyloric gland adenoma). (a) This example...

Figure 13.6 Oxyntic gland adenoma (a) showing an expansive, prolapse‐type gr...

Figure 13.7 Contrasting cytologic features of low‐ and high‐grade dysplasia ...

Figure 13.8 Intramucosal adenocarcinoma, characterised by markedly disorgani...

Figure 13.9 The five categories of the Borrmann classification for advanced ...

Figure 13.10 Gross appearance of gastric adenocarcinoma. (a) Borrmann type I...

Figure 13.11 Gastric adenocarcinoma, tubular variant. Note the morphological...

Figure 13.12 This microphotograph illustrates a well‐differentiated gastric ...

Figure 13.13 Gastric adenocarcinoma, papillary variant. The anastomosing fib...

Figure 13.14 Gastric adenocarcinoma, mucinous variant. The lower magnificati...

Figure 13.15 Poorly cohesive gastric carcinoma. (a and b) Signet‐cell varian...

Figure 13.16 Mixed gastric adenocarcinoma. (a) The neoplasm is composed of t...

Figure 13.17 (a) Tubular gastric adenocarcinoma with a gastric immunophenoty...

Figure 13.18 Two examples of adenosquamous gastric adenocarcinoma characteri...

Figure 13.19 Hepatoid adenocarcinoma and related entities. (a) Hepatoid gast...

Figure 13.20 Example of gastric adenocarcinoma with choriocarcinoma differen...

Figure 13.21 Gastric carcinoma with lymphoid stroma. (a) This neoplasm is co...

Figure 13.22 Gastric carcinosarcoma with admixed adenocarcinomatous and sarc...

Figure 13.23 Micropapillary variant of gastric adenocarcinoma. The tumour co...

Figure 13.24 Gastric adenocarcinoma of fundic gland type. (a) The lesion is ...

Figure 13.25 Macroscopic classification of early gastric carcinoma. The cate...

Figure 13.26 Microscopic lesions characteristic of hereditary diffuse gastri...

Figure 13.27 Adenocarcinoma of the stomach showing strong HER2 staining in m...

Figure 13.28 Cytology of gastric neuroendocrine tumours. The solid nests are...

Figure 13.29 Gastric neuroendocrine tumours. The expansile lesion displays a...

Figure 13.30 Precursor lesion of neuroendocrine tumours. The chromogranin st...

Figure 13.31 Gastric small‐cell neuroendocrine carcinoma. Prominent apoptosi...

Figure 13.32 Metastatic malignant melanoma to the stomach. (a) The normal ep...

Figure 13.33 Metastatic lobular breast carcinoma to the stomach. (a, b) Disc...

Figure 13.34 Metastatic pancreatic ductal adenocarcinosarcoma. This example ...

Chapter 14

Figure 14.1 Multiple GI stromal tumours (GISTs) distributed along the subser...

Figure 14.2 GI stromal tumour, spindle‐cell type composed of uniform spindle...

Figure 14.3 GI stromal tumour, epithelioid‐cell type has a cellular arrangem...

Figure 14.4 Different patterns of KIT staining in GISTs. (a) Diffuse and str...

Figure 14.5 Example of a dedifferentiated GIST. (a) Note the recognisable sp...

Figure 14.6 Example of an SDH‐deficient GIST of the stomach. (a) Hypercellul...

Figure 14.7 (a) Example of a gastric schwannoma demonstrating the circumscri...

Figure 14.8 Example of a variant schwannoma in the stomach. (a) Note the abs...

Figure 14.9 (a) Granular‐cell tumour composed of epithelioid cells with smal...

Figure 14.10 Gastric leiomyoma. (a) This hypocellular nodule is present in t...

Figure 14.11 Leiomyosarcoma, intermediate grade. (a) Moderately cellular neo...

Figure 14.12 Glomus tumour. (a) Low power shows a hypercellular nodule with ...

Figure 14.13 Example of a glomus tumour that behaved in a malignant fashion....

Figure 14.14 Kaposi sarcoma. (a) Monomorphic spindle cells that subtly expan...

Figure 14.15 (a) Gastric lipoma composed of mature adipocytes forming a nodu...

Figure 14.16 Plexiform fibromyxoma (plexiform angiomyxoid myofibroblastic tu...

Figure 14.17 Plexiform fibromyxoma (plexiform angiomyxoid myofibroblastic tu...

Figure 14.18 Clear‐cell sarcoma/malignant GNET. (a) Typical nested architect...

Figure 14.19 Synovial sarcoma. (a) This low‐power view illustrates a monopha...

Figure 14.20 Calcifying fibrous tumour. (a) Hyalinised fibrous tissue with a...

Chapter 15

Figure 15.1 Endoscopic ultrasonography appearances of gastric mucosa‐associa...

Figure 15.2 Endoscopic appearances of gastric mucosa‐associated lymphoid tis...

Figure 15.3 Macroscopic appearance of gastric MALT lymphoma surgically resec...

Figure 15.4 Patterns of infiltration of the neoplastic cells in gastric MALT...

Figure 15.5 Cytological aspects of gastric MALT lymphoma. (a) Small lymphoid...

Figure 15.6 Gastric MALT lymphoma with plasma‐cell differentiation. The cell...

Figure 15.7 Lympho‐epithelial lesions in gastric mucosa‐associated lymphoid ...

Figure 15.8 (a) Gastric MALT lymphoma with a nodular pattern and extensive f...

Figure 15.9 Low‐power view of a gastric MALT lymphoma showing a small mucosa...

Figure 15.10 Strong expression of BCL10 in a gastric MALT lymphoma harbourin...

Figure 15.11

H. pylori

‐associated gastritis with an atypical lymphoid infilt...

Figure 15.12 Infiltration and disruption of the muscularis mucosae in gastri...

Figure 15.13 Gastric involvement by MCL. (a) The nodular infiltrate seen in ...

Figure 15.14 Immunophenotyping of MCL. The neoplastic cells of MCL are posit...

Figure 15.15 (a) Crushed gastric biopsy showing a dense lymphoid infiltrate ...

Figure 15.16 Complete histological remission after antibiotic therapy for

H.

...

Figure 15.17 Probable minimal residual disease after antibiotic therapy for

Figure 15.18 Synchronous gastric MALT lymphoma and gastric adenocarcinoma of...

Figure 15.19 Primary gastric DLBCL massively involving the stomach as an ulc...

Figure 15.20 Gastric diffuse large B cell lymphoma. This tumour, composed of...

Figure 15.21 Patterns of gastric involvement in primary gastric DLBCL. (a) M...

Figure 15.22 (a) Gastric Burkitt lymphoma is characterised by a dense monoto...

Figure 15.23 HGBCL‐NOS cytologically intermediate between diffuse large B ce...

Figure 15.24 Peripheral T cell lymphoma, NOS, which presented as an ulcerate...

Figure 15.25 Gastric involvement by primary intestinal T cell lymphomas. (a–...

Figure 15.26 Secondary gastric involvement by a primary mediastinal large B ...

Chapter 16

Figure 16.1 Gastric dilatation. This plain abdominal radiograph demonstrates...

Figure 16.2 Gastric amyloidosis. In this example, the lamina propria is larg...

Figure 16.3 (a) An endoscopic image demonstrating a pharmacobezoar composed ...

Figure 16.4 Graft‐versus‐host disease of the stomach. (a) The lamina propria...

Figure 16.5 Dieulafoy disease. A ruptured dilated artery is seen close to th...

Figure 16.6 Endoscopic appearance of gastric antral vascular ectasis (GAVE):...

Figure 16.7 Microscopic appearance of GAVE with dilated, tortuous mucosal ca...

Figure 16.8 Gastric mucosal iron deposition. (a,b) Systemic iron overload ma...

Figure 16.9 Pseudo–signet‐ring cells. (a) The signet‐ring cells contain clea...

Figure 16.10 Gastric mucosal Langerhans cell histiocytosis. (a) Scanning vie...

Figure 16.11 Gastric crystal‐storing histiocytosis. (a) Histiocytic cells wi...

Chapter 17

Figure 17.1 Position of small intestine within the abdominal cavity.

Figure 17.2 Macroscopic image (a) and histology (b). The plicae circulares, ...

Figure 17.3 Position of the duodenum in relation to surrounding structures....

Figure 17.4 Illustration of the blood supply to the small and large bowel.

Figure 17.5 Scanning electron micrograph of normal duodenum. Finger‐ and lea...

Figure 17.6 Normal jejunal villi are long and slender mucosal projections co...

Figure 17.7 High‐magnification view of jejunal villi: columnar absorptive ce...

Figure 17.8 The combined Alcian blue and PAS stain highlights the red‐staini...

Figure 17.9 Transmission electron micrograph of the microvilli on the lumina...

Figure 17.10 A single crypt surrounded by lamina propria that contains migra...

Figure 17.11 Immunohistochemistry for chromogranin highlights numerous endoc...

Figure 17.12 Transmission electron micrograph of the duodenum showing a sero...

Figure 17.13 Muscularis propria: the ganglia of the mesenteric plexus of Aue...

Figure 17.14 An interstitial cell of Cajal as demonstrated by CD117 (c‐kit) ...

Figure 17.15 The serosa consists of a thin fibrous layer covered by a single...

Figure 17.16 The gastro‐duodenal junction. Note the transition from PAS‐posi...

Figure 17.17 Shorter and broader villi predominate in the duodenum. Underlyi...

Figure 17.18 Submucosal Brunner’s gland lobules drain via a duct that traver...

Figure 17.19 Histology of small bowel obtained by endoscopic biopsy from the...

Figure 17.20 The ileal mucosal villi appear shorter and more slender than th...

Figure 17.21 An organised lymphoid aggregate demonstrates the four zones: ge...

Figure 17.22 Dense brown‐black pigment is usually found in macrophages at th...

Chapter 18

Figure 18.1 Foetus, 12 weeks, with body stalk anomaly, including an abdomina...

Figure 18.2 Atretic ileum with preserved clusters of ganglion cells (arrowed...

Figure 18.3 Macroscopic picture of an ileal duplication cyst (arrowed) close...

Figure 18.4 Microscopy of a duplication cyst with focal gastric mucosa and h...

Figure 18.5 Multiple jejunal diverticula.

Figure 18.6 Meckel’s diverticulum with focal gastric mucosa.

Figure 18.7 Terminal ileum from a four‐day‐old child who had cystic fibrosis...

Figure 18.8 Section from the terminal ileum of an infant with cystic fibrosi...

Figure 18.9 Polypoid gastric heterotopia: a section of a polyp that was obst...

Figure 18.10 Heterotopic pancreatic tissue forming a ‘polyp’ and the lead po...

Figure 18.11 Lymphatic malformation of the ileal mesentery, with the typical...

Figure 18.12 Foetus with skeletal dysplasia (a) and extremely short small bo...

Chapter 19

Figure 19.1 H&E‐stained section (a) with accompanying elastin van Gieson’s (...

Figure 19.2 Intussusception in the terminal ileum. (a) Necrotic nodular mass...

Figure 19.3 Brown bowel syndrome: a segment of the involved small intestine ...

Figure 19.4 Idiopathic hollow visceral myopathy. Section of the ileal muscul...

Figure 19.5 Small intestine from a child with visceral myopathy. The muscula...

Figure 19.6 Polyglucosan body myopathy. Section of muscularis propria showin...

Chapter 20

Figure 20.1 Immunohistochemistry demonstrating adenovirus infection in the s...

Figure 20.2 Small‐intestinal mucosa in an AIDS patient. A classic cytomegalo...

Figure 20.3 Ulceration in cytomegalovirus enteritis. In patients with immune...

Figure 20.4 Yersiniosis showing confluent granulomas with central necrosis....

Figure 20.5 Yersiniosis. Endoscopic biopsy from the ileum showing a granulom...

Figure 20.6 Transverse ulceration of the ileum in tuberculosis.

Figure 20.7 (a) Coalescent epithelioid cell granulomas with central caseatio...

Figure 20.8 The histology of small‐intestinal

Mavium‐intracellulare

in...

Figure 20.9 A Ziehl–Neelsen stain of MAI infection in AIDS demonstrates innu...

Figure 20.10 Whipple’s disease in a duodenal biopsy. (a) Section stained by ...

Figure 20.11 Macrophages containing distinctive 2–4 μm, oval, narrow‐based b...

Figure 20.12 (a) A duodenal biopsy showing innumerable

Giardia lamblia

proto...

Figure 20.13 Cryptosporidiosis appears as small round structures attached to...

Figure 20.14 Electron microscopy of a

Cryptosporidium parvum

coccidian. It i...

Figure 20.15 Microsporidiosis in the small intestine. This is infection by

E

...

Figure 20.16

Leishmania donovani

infection in the duodenal mucosa of an AIDS...

Figure 20.17 Hyper‐infestation of the duodenal mucosa with

Strongyloides ste

...

Figure 20.18 Crohn’s disease. Staining with antibodies directed against (a) ...

Figure 20.19 (a) Crohn’s disease in the ileum. Numerous aphthous ulcers are ...

Figure 20.20 One of the important complications of Crohn’s disease is ‘fistu...

Figure 20.21 Multiple short small‐intestinal strictures in Crohn’s disease....

Figure 20.22 Cobblestoning of the mucosa in Crohn’s disease. Intercommunicat...

Figure 20.23 Giant inflammatory polyp in Crohn’s disease in the terminal ile...

Figure 20.24 A Crohn’s disease stricture of the ileum demonstrating the mark...

Figure 20.25 Crohn’s disease of the ileum demonstrating the marked thickenin...

Figure 20.26 An ileoscopic biopsy demonstrating two well‐formed epithelioid ...

Figure 20.27 (a) A whole‐mount section of jejunal Crohn’s disease. The trans...

Figure 20.28 An ileal biopsy from a patient with Crohn’s disease. It shows a...

Figure 20.29 Ileal biopsy with villous abnormalities, dilated lymphatic, bif...

Figure 20.30 A whole‐mount section of jejunal Crohn’s disease. There is tran...

Figure 20.31 The presence of numerous dilated lymphatics in the submucosa an...

Figure 20.32 Crohn’s disease: giant cell close to lymphatics.

Figure 20.33 An ileoscopic biopsy from a patient with Crohn’s disease. Villo...

Figure 20.34 Dysplasia in small‐intestinal Crohn’s disease. The dysplasia (l...

Figure 20.35 The opened terminal ileum showing backwash ileitis from a total...

Figure 20.36 The histology of backwash ileitis shows villous atrophy, diffus...

Figure 20.37 Duodenal biopsy from a patient with severe, extensive ulcerativ...

Figure 20.38 (a) A ‘solitary ulcer’ of the small intestine as seen on macros...

Figure 20.39 A classical black‐and‐white picture from the original Price stu...

Figure 20.40 Further classical black‐and‐white pictures from the original Pr...

Figure 20.41 Ileal biopsy showing focal inflammation with flattening of surf...

Figure 20.42 (a) Medications may cause a sprue‐like small‐intestinal mucosal...

Figure 20.43 Eosinophilic enteritis. Although the mucosa is intact, there is...

Figure 20.44 Mastocytosis of the ileum (a) showing the presence of numerous ...

Figure 20.45 Chronic radiation enteritis. This was from an area of stricture...

Figure 20.46 Behçet’s disease of the ileum. The edge of a deeply penetrating...

Figure 20.47 A mucosal biopsy from a pelvic ileal reservoir. The biopsy show...

Figure 20.48 Pouchitis in a pelvic ileal reservoir. There is villous atrophy...

Figure 20.49 Villous atrophy and chronic inflammation are commonly seen in t...

Figure 20.50 Mucosal prolapse changes in the ileal mucosa of an ileostomy. T...

Figure 20.51 Chronic duodenitis with extensive gastric metaplasia at right....

Chapter 21

Figure 21.1 Mild abnormality in gluten‐induced enteropathy: villi are preser...

Figure 21.2 Marsh stage 3b lesion of gluten‐induced enteropathy characterise...

Figure 21.3 Marsh stage 3c lesion of gluten‐induced enteropathy. This is the...

Figure 21.4 A ‘flat’ mucosa showing a mosaic pattern. The raised mounds of e...

Figure 21.5 Endoscopic appearance of a flat mucosa in gluten‐induced enterop...

Figure 21.6 Villus in Marsh stage 1 gluten‐induced enteropathy demonstrating...

Figure 21.7 Inflammation in the lamina propria, thickening of the subepithel...

Figure 21.8 (a) Increased IELs with preserved villous architecture in a pati...

Figure 21.9 (a) Refractory coeliac disease type 2. Note the absence of atypi...

Figure 21.10 (a) Collagenous sprue characterised by deposition of collagen i...

Figure 21.11 Cows’ milk protein intolerance characterised by inflammation in...

Figure 21.12 Coeliac disease‐like pattern of AIE. Inflammation in the lamina...

Figure 21.13 Duodenal biopsy from a patient with common variable immunodefic...

Figure 21.14 Mild histological changes of tropical sprue. Note that the intr...

Figure 21.15 Olmesartan‐related enteropathy characterised by villous bluntin...

Figure 21.16 Abetalipoproteinaemia: note the clear lipid‐filled cytoplasmic ...

Figure 21.17 Tufting enteropathy showing characteristic tufts of rounded epi...

Figure 21.18 Intestinal lymphangiectasia. Section of an ileal biopsy showing...

Figure 21.19 Waldenström’s macroglobulinaemia. There is deposition of eosino...

Chapter 22

Figure 22.1 A mucosal telangiectasia consists of variably dilated, thin‐wall...

Figure 22.2 (a) Angiodysplasias appear as disorganised aggregates of veins a...

Figure 22.3 An arteriovenous malformation from a patient with hereditary hae...

Figure 22.4 Patients with blue rubber bleb syndrome develop multiple blue no...

Figure 22.5 Cholesterol emboli cause ischaemic enteritis in this patient who...

Figure 22.6 Intussusception of the terminal ileum and its mesentery leads to...

Figure 22.7 Acute ischaemic enteritis results in patchy mucosal necrosis. Sl...

Figure 22.8 Enteric ischaemia affects the villi first. (a) Sloughed necrotic...

Figure 22.9 Ischaemia‐induced strictures result from mural fibrosis, particu...

Figure 22.10 Radiation‐induced chronic ileal ischaemia results in mucosal re...

Figure 22.11 (a) Sodium polystyrene sulfonate is a cation‐exchange resin tha...

Figure 22.12 Polyarteritis nodosa affects a medium‐sized artery in the submu...

Figure 22.13 Eosinophilic granulomatosis with polyangiitis shows a predilect...

Figure 22.14 Henoch–Schönlein purpura is easily overlooked in biopsy samples...

Figure 22.15 This patient with longstanding rheumatoid arthritis and an ilea...

Figure 22.16 Behcet’s disease causes chronic ulcers that more closely simula...

Figure 22.17 The small intestine from an elderly patient with venous outflow...

Chapter 23

Figure 23.1 (a) Whipple specimen showing a large mainly sessile adenoma (das...

Figure 23.2 Diagram illustrating the frequency of occurrence of duodenal and...

Figure 23.3 Examples of low Spigelman stage (stage I‐II, left) and high Spig...

Figure 23.4 (a) Peutz–Jeghers patient with documented LKB1 germline mutation...

Figure 23.5 Example of a small intestinal Peutz–Jeghers polyp with extensive...

Figure 23.6 (a) Endoscopic picture of a juvenile polyp in the duodenum of a ...

Figure 23.7 (a) Histological section of a juvenile polyp from a juvenile pol...

Figure 23.8 Example of a ‘clean‐sweep’ polypectomy in a patient with Cowden ...

Figure 23.9 Endoscopic picture of (a) the duodenum and (b) the jejunum of a ...

Figure 23.10 (a) Macroscopic appearance of a Brunner gland hamartoma. (b) Hi...

Figure 23.11 Histological section of a pyogenic granuloma in the small bowel...

Chapter 24

Figure 24.1 A stenosing carcinoma of the jejunum that presented with obstruc...

Figure 24.2 Adenocarcinoma of jejunum arising in a pre‐existing adenoma. The...

Figure 24.3 Recurrent small bowel adenocarcinoma two years post‐resection of...

Figure 24.4 Microscopic duodenal gastrinoma in a patient with Zollinger–Elli...

Figure 24.5 A duodenal gastrinoma. (a) Low‐power view showing a well differe...

Figure 24.6 Duodenal ampullary somatostatinoma (a) with a prominent glandula...

Figure 24.7 Macroscopic appearance of an enterochromaffin‐cell tumour (carci...

Figure 24.8 Ileal endocrine tumour showing how such tumours often cause retr...

Figure 24.9 Elastic vascular sclerosis associated with an ileal enterochroma...

Figure 24.10 Histology of an NET of the ileum: note the insular pattern with...

Figure 24.11 Small‐intestinal ET showing how the neoplastic cells insinuate ...

Figure 24.12 Metastatic colonic adenocarcinoma to the small intestine, mimic...

Chapter 25

Figure 25.1 Favoured layers of various spindle‐cell tumours in the small int...

Figure 25.2 Metastatic sarcomatoid urothelial carcinoma involving the small ...

Figure 25.3 Features of small‐intestinal GISTs. This image shows prominent c...

Figure 25.4 Features of small‐intestinal GISTs. (a) This duodenal GIST arose...

Figure 25.5 So‐called gastrointestinal autonomic nerve tumour (GANT). These ...

Figure 25.6 Dedifferentiated GIST. (a) The top part of the image shows a typ...

Figure 25.7 Smooth‐muscle tumours of the small bowel. (a) This leiomyoma of ...

Figure 25.8 Mesenteric fibromatosis (desmoid tumour). (a) At low magnificati...

Figure 25.9 Sclerosing mesenteritis. (a) Imaging study showing the lesion in...

Figure 25.10 Diagram outlining a possible relationship between inflammatory ...

Figure 25.11 Inflammatory myofibroblastic tumour. (a) This inflammatory lesi...

Figure 25.12 Epithelioid inflammatory myofibroblastic sarcoma. This can be c...

Figure 25.13 IgG4‐related fibrosclerosing disease. (a) At low magnification,...

Figure 25.14 Calcifying fibrous pseudo‐tumour. (a) At low magnification, the...

Figure 25.15 Follicular dendritic‐cell sarcoma. (a) Because of their tendenc...

Figure 25.16 Dedifferentiated liposarcoma extending into the small bowel fro...

Figure 25.17 Vascular malformation extending into the small bowel. (a) Large...

Figure 25.18 Kaposi’s sarcoma. (a) At low magnification, visceral Kaposi’s s...

Figure 25.19 Angiosarcoma of the jejunum. (a) This angiosarcoma involving th...

Figure 25.20 Lymphangioma/lymphangiomatosis/lymphatic malformation resected ...

Figure 25.21 Primary and secondary lymphangiectasia of the duodenum. (a) In ...

Figure 25.22 A small‐intestinal mesenteric lymphatic cyst. It is large and m...

Figure 25.23 Schwannoma of the small intestine. (a) The lesion is centred in...

Figure 25.24 Ganglioneuromatosis. (a) This lesion infiltrated all layers of ...

Figure 25.25 Inflammatory fibroid polyp of the small bowel. (a) This lesion ...

Figure 25.26 Ewing’s sarcoma of the duodenum. (a) ‘Round blue cell tumours’ ...

Figure 25.27 GI clear‐cell sarcoma‐like tumour. (a) At low magnification, th...

Chapter 26

Figure 26.1 Nodular lymphoid hyperplasia of the ileum. Multiple expansile ly...

Figure 26.2 A large ulcerating diffuse large B‐cell lymphoma of the small in...

Figure 26.3 Diffuse large B‐cell lymphoma not otherwise specified of the sma...

Figure 26.4 Plasmablastic lymphoma of the jejunum. Biopsies of an ulcerated ...

Figure 26.5 Burkitt lymphoma involving the ileum. Endoscopy showed polypoid ...

Figure 26.6 MALT lymphoma of the small intestine. (a) This jejunal tumour pr...

Figure 26.7 Immunoproliferative small intestinal disease: neoplastic plasma ...

Figure 26.8 Duodenal‐type FL. Duodenal biopsy showing a nodular and diffuse ...

Figure 26.9 Mantle cell lymphoma grossly presenting as large polypoid mucosa...

Figure 26.10 Jejunal lymphoma presenting as a stricture in the setting of co...

Figure 26.11 Enteropathy‐associated T‐cell lymphoma. The small bowel wall sh...

Figure 26.12 Monomorphic epitheliotropic intestinal T‐cell lymphoma. This tu...

Figure 26.13 Indolent T‐lymphoproliferative disorder of the GI tract. Low‐ma...

Figure 26.14 Monomorphic post‐transplantation lymphoproliferative disorder p...

Figure 26.15 Histiocytic sarcoma presenting as a small intestinal mass (a). ...

Chapter 27

Figure 27.1 (a) A medium‐power view of small‐bowel submucosa showing amorpho...

Figure 27.2 Pneumatosis cystoides intestinalis. (a) Gross photograph of inte...

Figure 27.3 High‐power view of duodenal mucosa with graft‐versus‐host diseas...

Chapter 28

Figure 28.1 Recommended method of dissecting the appendix. Black lines repre...

Chapter 29

Figure 29.1 Aggregates of smooth muscle cells in the muscularis propria show...

Figure 29.2 Intravascular lymphocytes in the appendiceal wall have a uniform...

Figure 29.3 (a) Fibrous obliteration of the appendix tends to be most pronou...

Figure 29.4 The acutely inflamed appendix is dilated distally, with a conges...

Figure 29.5 (a) Extensive ulcers are present in this cross‐section of the ap...

Figure 29.6 (a) Delayed appendicectomy specimens contain linear arrays of ly...

Figure 29.7 This appendix was removed one year after an episode of appendici...

Figure 29.8 Ulcerative appendicitis resembles ulcerative colitis. The mucosa...

Figure 29.9 High numbers of eosinophils are often seen in appendicectomy spe...

Figure 29.10 Aggregates of degranulated or necrotic eosinophils are associat...

Figure 29.11 (a) Yersiniosis typically causes an acute appendicitis with epi...

Figure 29.12 (a) Actinomyces are filamentous bacteria that elicit a granulom...

Figure 29.13 A longitudinal section of Enterobius vermicularis in the append...

Figure 29.14 (a) Histoplasmosis elicits granulomatous inflammation with poor...

Chapter 30

Figure 30.1 Gross photograph of an appendix with extrusion of mucus on the s...

Figure 30.2 Low‐grade appendiceal mucinous neoplasm. This lesion shows an un...

Figure 30.3 Low‐grade appendiceal mucinous neoplasm. The epithelium is flatt...

Figure 30.4 High‐grade appendiceal mucinous neoplasm. There is high‐grade cy...

Figure 30.5 Invasive mucinous adenocarcinoma. Irregular infiltration of the ...

Figure 30.6 Appendiceal serrated polyp without dysplasia showing elongated c...

Figure 30.7 Mucosal hyperplasia of the appendix. The appendiceal mucosa in t...

Figure 30.8 Gross photograph of neuroendocrine tumour in the appendix: a whi...

Figure 30.9 Appendiceal neuroendocrine tumour of EC‐cell type. Low‐power vie...

Figure 30.10 Appendiceal neuroendocrine tumour of EC‐cell type. High power r...

Figure 30.11 Appendiceal neuroendocrine tumour of EC‐cell type. S‐100 immuno...

Figure 30.12 Tubular neuroendocrine tumour of the appendix. A proliferation ...

Figure 30.13 Goblet‐cell adenocarcinoma. Infiltration of the muscularis prop...

Figure 30.14 Goblet‐cell adenocarcinoma. High‐power view of the tumour clust...

Figure 30.15 Goblet‐cell adenocarcinoma, high grade. Cells with atypical ves...

Figure 30.16 Granular‐cell tumour of the appendix. The submucosa contains in...

Figure 30.17 Luminal fibrosis (axial neuroma) of the appendix. The typical s...

Chapter 31

Figure 31.1 Diverticulosis. The muscular wall of the appendix is thick and p...

Figure 31.2 Intussusception due to endometriosis. Lying within the dilated a...

Figure 31.3 Torsion. A section of the proximal appendix (left) is normal, co...

Figure 31.4 Decidual reaction: the nodule is subserosal.

Figure 31.5 Vernix caseosa. (a) The appendix shows a serosal acute inflammat...

Figure 31.6 Foreign body. (a) In this case, an iron tablet impacted in the b...

Figure 31.7 Insoluble drug crystals. (a) The bile acid sequestrants coleseve...

Chapter 32

Figure 32.1 (a) Anterior and (b) posterior views of a fresh abdomino‐perinea...

Figure 32.2 Fresh subtotal colectomy specimen for multiple colonic tumours. ...

Figure 32.3 Grading the plane of surgery for the mesorectum. (a) Note the in...

Figure 32.4 Grading the plane of surgery around the anal sphincters in abdom...

Figure 32.5 Grading the plane of colonic cancer surgery. (a) Note the intact...

Figure 32.6 Cross‐sectional slices from an anterior resection specimen for r...

Figure 32.7 Low‐power H&E view of the colonic wall. (A) Colonic mucosa is se...

Figure 32.8 Low‐power H&E view of colonic mucosa taken from both (a) right a...

Figure 32.9 Endocrine cells in the colonic crypt stained with synaptophysin....

Figure 32.10 The colonic stem‐cell niche and spatial distribution of cellula...

Figure 32.11 Colon mucosa immunostained with the lymphatic endothelial marke...

Chapter 33

Figure 33.1 Diagram showing the rotation that occurs during the development ...

Figure 33.2 Diagram showing the position of the cloacal membrane.

Figure 33.3 Diagrams showing the progressive embryological development of th...

Figure 33.4 Resected rectum and sigmoid colon in Hirschsprung’s disease, sho...

Figure 33.5 Myenteric plexus in Hirschsprung’s disease. Enlarged wavy nerve ...

Figure 33.6 Acetylcholinesterase preparation from a fresh rectal biopsy in H...

Chapter 34

Figure 34.1 Diverticular disease of the colon. Note the concertina‐like appe...

Figure 34.2 Diverticular disease of the sigmoid colon showing mucosal redund...

Figure 34.3 (a) Nipple‐like tags of mucosa formed by everted colonic mucosal...

Figure 34.4 A redundant tag of mucosa in sigmoid diverticular disease showin...

Figure 34.5 Diverticular disease with diverticulitis. Part of the wall of th...

Figure 34.6 Diverticular disease of sigmoid colon with a pericolic abscess t...

Figure 34.7 Isolated diverticulum of the right colon. Mucosal ulceration (ar...

Figure 34.8 Familial visceral myopathy of autosomal recessive type. There is...

Figure 34.9 Systemic sclerosis: histological appearances of the transverse c...

Figure 34.10 Muscular dystrophy: the histological appearances of the transve...

Figure 34.11 A single amphophilic inclusion body within a myocyte lies close...

Figure 34.12 Ganglio‐neuroma‐like expansion of myenteric plexus in the colon...

Figure 34.13 Autonomic plexitis. The colonic myenteric plexus is infiltrated...

Figure 34.14 Solitary ulcer of the rectum. Despite the name, these lesions a...

Figure 34.15 Histology of the edge of a solitary rectal ulcer (proctectomy s...

Figure 34.16 Solitary rectal ulcer syndrome. In this case, there is misplace...

Chapter 35

Figure 35.1 CMV (CMV). (a) Rectal mucosal biopsy from a patient with longsta...

Figure 35.2 CMV IHC demonstrating multiple CMV inclusions. They are within t...

Figure 35.3 Adenovirus infection. Surface epithelial cells show pseudostrati...

Figure 35.4 HSV (HSV). Numerous HSV inclusions in an area of ulceration of s...

Figure 35.5 HIV may cause intestinal mucosal inflammatory changes that are o...

Figure 35.6

Salmonella typhi

causing colonic mucosal ulceration. The adjacen...

Figure 35.7

Campylobacter jejuni

colitis. (a) Neutrophil cryptitis, lamina p...

Figure 35.8 Pseudomembranous colitis: macroscopic appearance. (a) A colectom...

Figure 35.9 Pseudomembranous colitis: histology. (a) An extensive volcano‐li...

Figure 35.10 (a) Macroscopic appearance of colonic tuberculosis (TB). There ...

Figure 35.11 Histology of TB. The images are from a large colonic lesion tha...

Figure 35.12 Yersiniosis of the colon. There are multiple granulomas, some w...

Figure 35.13 LGV proctitis. Features can mimic IBD clinically and histologic...

Figure 35.14 Rectal syphilis. There is mucosal and submucosal chronic inflam...

Figure 35.15 Intestinal spirochaetosis (

Brachyspira aalborgi

/

Brachyspira pil

...

Figure 35.16 Histoplasmosis yeast forms demonstrated by a Grocott stain.

Figure 35.17 Microsporidiosis. Groups of small spores are present within epi...

Figure 35.18 Amoebic colitis: macroscopic appearance. A colonic resection sh...

Figure 35.19 Amoebic colitis: histology. (a) Low‐power view of a characteris...

Figure 35.20

Balantidium coli

. A large protozoon with a large nucleus that m...

Figure 35.21

Cryptosporidium parvum

infection of the large intestine. In thi...

Figure 35.22

Cystoisospora belli

. Two parasites are identifiable. They have ...

Figure 35.23 Intestinal schistosomiasis. (a) Large‐bowel mucosa showing nume...

Figure 35.24 Perianal schistosomiasis. (a) Macroscopically and on low‐power ...

Figure 35.25

Strongyloides stercoralis

infection of the large bowel. (a) Sev...

Figure 35.26 UC: endoscopic appearances. (a) Retroflexed view of the rectum ...

Figure 35.27 Crohn’s disease: endoscopic appearances. There are multiple foc...

Figure 35.28 UC: macroscopic appearances. (a) Severe UC extending continuous...

Figure 35.29 Discontinuity in UC. (a) Rectal sparing in UC, with diffuse col...

Figure 35.30 UC resection histology. (a) UC showing typical mucosa‐predomina...

Figure 35.31 Longstanding treated UC often shows discontinuity and patchines...

Figure 35.32 A cryptolytic granuloma is present in the appendix from a color...

Figure 35.33 Aphthous ulcers in Crohn’s disease. (a) Endoscopic appearance o...

Figure 35.34 Macroscopic appearances of Crohn’s disease. (a) A right hemicol...

Figure 35.35 (a) A stricture in Crohn’s disease showing ulceration, chronic ...

Figure 35.36 Crohn’s disease showing a fissure ulcer with a typical knife‐li...

Figure 35.37 Transmural chronic inflammation with lymphoid aggregates in a C...

Figure 35.38 Healing after ulceration in IBD and other colitides can result ...

Figure 35.39 Fulminant UC with toxic megacolon. In this example, there is di...

Figure 35.40 Histology of a case of fulminant colitis with extensive, deep u...

Figure 35.41 Crohn’s‐like features in UC resections. (a) Transmural chronic ...

Figure 35.42 IBD in biopsies. (a) Mucosal biopsy features typical of new unt...

Figure 35.43 Mucosal chronic inflammation in IBD. (a) Basal plasmacytosis – ...

Figure 35.44 Neutrophil activity in IBD. Cryptitis and crypt abscesses are s...

Figure 35.47 Granulomas in Crohn’s disease. (a) A colonic biopsy from a pati...

Figure 35.48 (a) A cryptolytic granuloma: i.e. a granulomatous reaction to c...

Figure 35.49 Infective colitis compared with IBD. (a) Infective colitis show...

Figure 35.50 A comparison between UC (a) and infective colitis (b). (a) Cryp...

Figure 35.51 Distribution of disease in IBD biopsies. (a) In new untreated U...

Figure 35.52 Inactive (quiescent) UC. There is crypt atrophy, mild crypt dis...

Figure 35.53 Inactive UC in a rectal biopsy showing persistent mucosal chron...

Figure 35.54 New Crohn’s disease. (a) Mucosal chronic inflammation with basa...

Figure 35.55 Post‐colectomy UC‐related panenteritis. After colectomy, UC occ...

Figure 35.56 UC in the setting of PSC may be mainly right sided, especially ...

Figure 35.57 Dysplasia in IBD. (a) LGD in the setting of IBD. There is failu...

Figure 35.58 (a) Serrated dysplasia in IBD. (b) Hypermucinous dysplasia with...

Figure 35.59 Non‐dysplastic epithelial serration can occur in non‐polypoid m...

Figure 35.60 (a) Macroscopic appearance of an area of dysplasia in UC. Resec...