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Navigating the jungles of tropical infectious gastrointestinal pathology: a pattern-based approach to the endoscopic
Tomas Slavik1,2,3, Gregory Y Lauwers4
1Ampath Pathology Laboratories, Pretoria, South Africa. slavikt@ampath.co.za.
Abstract:
International travels and global human migration have had the unforeseen consequence of increasing the exposure of histopathologists in developed countries to the pathology of tropical infectious disease. The gastrointestinal tract (GIT) is often the primary site of infection due to the faecal-oral route of transmission and the high risk of exposure to contaminated water, food or soil when travelling to these regions. Whilst current microbiologic techniques are far more sensitive than histology in detecting infectious pathogens, the histopathologist nonetheless retains a pivotal role in diagnosing tropical GIT disease. This role entails evaluating endoscopic biopsies for any characteristic inflammatory pattern, identifying pathogens which may be present and excluding other look-alike pathologies. Recent advances in commercially available diagnostic modalities, including molecular techniques, have further broadened the scope of the histopathologist's armamentarium. This review outlines a practical pattern-based approach to diagnosing tropical GIT infections in endoscopic material, so as to assist pathologists less familiar with this spectrum of pathology.
Insights
Histopathologists increasingly encounter tropical infectious diseases, particularly in the gastrointestinal tract (GIT). This review offers a pattern-based approach to diagnosing these infections in endoscopic biopsies, aiding pathologists unfamiliar with tropical pathology.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Histopathology
Background:
- Global travel and migration increase exposure of histopathologists to tropical infectious diseases.
- The gastrointestinal tract (GIT) is a common site for tropical infections due to the fecal-oral transmission route.
Purpose of the Study:
- To provide a practical, pattern-based approach for diagnosing tropical GIT infections in endoscopic biopsies.
- To assist histopathologists less familiar with the pathology of tropical infectious diseases.
Main Methods:
- Review of literature and diagnostic patterns for tropical GIT infections.
- Focus on histopathological evaluation of endoscopic biopsies.
- Integration of recent advances in diagnostic modalities, including molecular techniques.
Main Results:
- Histopathology remains crucial for diagnosing tropical GIT disease, complementing microbiologic techniques.
- Identifying characteristic inflammatory patterns and pathogens is key.
- Exclusion of mimickers of tropical infections is an important role.
Conclusions:
- A systematic, pattern-based approach enhances the diagnosis of tropical GIT infections.
- Histopathologists play a vital role in identifying these diseases, even with advanced molecular tools.
- Familiarity with tropical GIT pathology is essential for accurate diagnosis in a globalized world.
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