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Selected topics in the evaluation of pediatric gastrointestinal mucosal biopsies
Jennifer R Scudiere1, Anirban Maitra, Elizabeth A Montgomery
1Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD 21231-2410, USA.
Insights
Pediatric gastrointestinal pathology presents unique challenges. This review offers diagnostic tips for common pediatric GI conditions like eosinophilia, foreign body ingestion, colitis, and Hirschsprung disease.
Area of Science:
- Gastroenterology
- Pediatric Pathology
Background:
- Pediatric gastrointestinal (GI) pathology presents unique diagnostic challenges.
- Clinical information is often limited, such as "failure to thrive."
- High-pressure situations, like evaluating neonates for Hirschsprung disease, require specialized expertise.
Purpose of the Study:
- To provide a review of commonly encountered situations in pediatric GI pathology.
- To offer diagnostic strategies and tips for specific pediatric GI conditions.
- To help pathologists avoid pitfalls and effectively communicate findings to pediatric gastroenterologists.
Main Methods:
- Review of common pediatric GI pathology scenarios.
- Discussion of diagnostic approaches, tips, and pitfalls for each scenario.
- Highlighting key references for communication with pediatric gastroenterologists.
Main Results:
- Provides a structured approach to evaluating pediatric esophageal eosinophilia.
- Offers guidance on managing cases of foreign body, caustic substance, or hot liquid ingestion.
- Details the evaluation of pediatric colorectal biopsies for focal active colitis.
- Explains the assessment of rectal suction biopsies for Hirschsprung disease.
Conclusions:
- Effective management of pediatric GI pathology requires specific knowledge and strategies.
- Understanding common pitfalls is crucial for accurate diagnosis.
- Clear communication of pathological findings aids in optimal patient care for pediatric GI conditions.
Abstract:
The practice of pediatric gastrointestinal pathology provides specific challenges to the pathologist. Often the clinical information accompanying a biopsy specimen will read simply, "failure to thrive." Other situations, such as the evaluation of a neonate's rectal suction biopsy for Hirschsprung disease, are notorious for providing diagnostic challenges in high-pressure situations. In this review, we will discuss several commonly encountered situations in pediatric pathology: the evaluation of pediatric esophageal eosinophilia, a child who has swallowed a non food item, caustic substance, or hot liquid, the evaluation of a pediatric colorectal biopsy with focal active colitis, and the evaluation of rectal suction biopsies for Hirschsprung disease. With each topic, we will discuss a general approach to the case, diagnostic tips, and how to avoid commonly encountered pitfalls. Finally, we highlight key references pertinent to these issues that can he used to help convey pathologic findings to pediatric gastroenterologists.
