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Updated: May 22, 2025

DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens

DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens

Published on: February 1, 2020

Banff 2022 pancreas pathology update: how to make the right diagnosis and decrease inconclusive pathology results.

Cinthia B Drachenberg¹, Surya V Seshan², John C Papadimitriou¹

¹Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.

Current Opinion in Organ Transplantation

|May 21, 2025

Summary

This summary is machine-generated.

Pancreas transplant biopsies can be challenging. Integrating clinical data with pathology improves diagnosis and reduces indeterminate findings, enhancing patient care.

Keywords:

acute rejection exocrine drainage indeterminate Banff category pancreas allograft biopsy peripancreatitis

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Last Updated: May 22, 2025

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Area of Science:

Transplant Pathology
Immunopathology
Gastroenterology

Background:

The Banff 2022 update refined pancreas transplant rejection criteria but highlighted challenges in biopsy interpretation.
Clinicopathological discrepancies and inconclusive findings create uncertainty in clinical decision-making for pancreas transplant recipients.

Purpose of the Study:

To expand on the Banff 2022 report by addressing common causes of inconclusive pancreas allograft biopsy diagnoses.
To provide an algorithm to aid in the interpretation of pancreas allograft biopsy morphology.

Main Methods:

Review of common scenarios leading to "indeterminate" Banff categories in pancreas allograft biopsies.
Discussion of entities including nonspecific infiltrates, post-treatment inflammation, ischemic pancreatitis, and drainage impairment.
Development of an evaluation algorithm for pancreas allograft biopsies.

Main Results:

Identified key differential diagnoses for inconclusive pancreas transplant biopsy findings.
Presented specific conditions that contribute to diagnostic uncertainty, such as nonspecific infiltrates and ischemic pancreatitis.
An algorithm was developed to assist in interpreting morphological findings in pancreas allograft biopsies.

Conclusions:

Systematic integration of clinical information with pathology findings is crucial for improving diagnostic yield.
Combining clinical and pathological data can significantly reduce the rate of "indeterminate" diagnoses in pancreas allograft biopsies.
Enhanced diagnostic accuracy supports better clinical and pathological decision-making in pancreas transplantation.