Qap (Anatomical Pathology) 

QAP Peer Review

AP241
Case History: F/84. Gastrointestinal bleeding. Endoscopy revealed duodenal ulcer. Gastric biopsy done.
Intended diagnosis: Resonium associated gastric ulcer. Contributed by:JKCC
Code Diagnosis Comment Score
anonymous Kayexalate associated gastric ulcer, candida present (100%) nil  100
anonymous Gastric ulcer with fungal infection nil  80
anonymous KAYEXALATE ASSOCIATED GASTRIC EROSION To correlate with drug history for previous Resonium C treatment  100
anonymous Peptic ulcer; resonium deposits nil  100
anonymous Helicobacter-negative ulcer and chronic gastritis with focal intestinal metaplasia and candida organisms and foreign bodies. 100% Special stain to determine the nature of the foreign bodies eg. von kossa stain for calcium. Deeper sections to look for malignancy as one tiny focus of degenerated atypical glandular epithelium is seen embedded within the ulcer exudate. Candidiasis can sometimes be associated with stasis. Obstruction and tumor are to be looked for clinically.  80
anonymous Benign ulcer with presence of resonium.(100%) nil  100
anonymous Gastric biopsy - Resonium A associated gastric mucosal injury 100% nil  100
anonymous Ulceration with tablet material (100%), suggestive of resonium Fungal hyphae noted nil  100
anonymous Kayexalate related ulcer. 100% nil  100
anonymous Peptic ulcer with presence of bluish Rhomboid materials (Medication?) in between mixed bacteria flora and fungi. Need to correlate with any medication for chronic renal insufficiency.  90
anonymous Stomach, biopsy - Ulcer with intestinal metaplasia and ion exchange resin (polystyrene sulfonate). Please correlate with clinical history of whether ion exchange resin (polystyrene sulfonate) is given for lowering potassium level.  100
anonymous Ulcer with kayexalate crystals nil  100
anonymous Resonium associated gastric ulcer, candida present. (100% probability) nil  100
anonymous Kayexalate resin crystal related gastric ulcer (100%) Please correlate with drug history and exclude adminstration of resonium compound  100
anonymous STOMACH, biopsy - Benign ULCER, kayexalate crystals seen (100%) nil  100