Qap (Anatomical Pathology) 

QAP Peer Review

AP338
Case History: M/69. Total gastrectomy for ca stomach. Sampling from non-tumorous area.
Intended diagnosis: HP gastritis (coccoid form). Contributed by:PC
Code Diagnosis Comment Score
anonymous Zollinger-Ellison syndrome, Helicobacter pylori present. A group of atypical cells is seen at the edge. Suggest correlate with morphology of the atypical cells with the main tumour histology.  1000
anonymous Zollinger-Ellison syndrome nil  40
anonymous ZOLLINGER-ELLISON SYNDROME (80%) DIEULAFOY LESION (CALIPER PERSISTENT ARTERY OF THE STOMACH) (20%) nil  40
anonymous Helicobacter (coccoid form) associated active chronic gastritis 100%. Suggestive of hypertrophic gastropathy Correlate with gross findings and clinical history of possible Zollinger-Ellison syndrome.  100
anonymous Menetrier disease complicated with a patch of carcinoma at the edge of the section. Coccoid form of Helicobacter pylori-associated chronic active gastritis. Mucicarmine stain to confirm the carcinoma being adenocarcinoma.  100
anonymous Chronic inactive gastritis with Helicobacter pylori (coccoid form) nil  100
anonymous Stomach - No malignancy. Coccoid form of Helicocacter pylori organisms seen 100% nil  100
anonymous Hypertrophic gastropahty + a tiny focus of Malignant Cells at the edge nil  40
anonymous Helicobacter-associated active chronic gastritis; Focal presence of suspicuous cells; Areas suggestive of parietal cell hyperplasia, Zollinger-Ellison syndrome needs to be excluded. nil  100
anonymous Chronic active gastritis and presence of coccoid bacterial, favoring coccoid form of Helicobacter pylori. Alteration suggestive of hyperplastic glandular / acinar compartment of mucosa. Presence of single large artery located high at submucosa, with feature suspicious of Dieulafoy disease nil  100
anonymous STOMACH - ACTIVE CHRONIC GASTRITIS with some coccoid-form microorganism (for immunostaining for Helicobacter pylori); Abnormal thick-wall blood vessel in submucosa with unknown significance nil  100
anonymous Helicobacter associated gastritis nil  100
anonymous Abnormal submucosal vessel and Helicobacter pylori (coccoid form) present. (100%) The presence of abnormal large artery in the submucosa may represent Dieulafoy’s lesion. Immunohistochemical staining for Helicobacter pylori would be performed to confirm the presence of Helicobacter pylori (coccoid form). Small number of probably carcinoma cells are identified at the edge of the histologic section received, but the amount is too scanty for proper assessment and this finding probably represents incidental exposure on step sectioning instead of the intended focus.  100
anonymous active chronic gastritis with coccoid Helicobacter organisms; prominent gastric folds with hyperplasia of parietal cells, need to exclude Zollinger-Ellison syndrome (?underlying gastrinoma) (100%) nil  100
anonymous Giant gastric rugae due to hyperplasia of gastric body parietal glands, consistent with Zollinger Ellison Syndrome (100% Probability). nil  40
anonymous Consistent with Dieulafoy's lesion nil  40
anonymous Zollinger-Ellison syndrome (100%) nil  40
anonymous Stomach - Active chronic gastritis; no evidence of malignancy. Perform immunohistochemical staining for confirming the presence of Helicobacter pylori. The possibilities of an incidental Dieulafoy lesion and hypertrophic gastropathy may be considered.  60