Gastrointestinal Pathology: An Atlas and Text PDF
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GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page i Aptara (PPG-Quark) GASTROINTESTINAL PATHOLOGY An Atlas and Text THIRD EDITION GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page ii Aptara (PPG-Quark) GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page iii Aptara (PPG-Quark) GASTROINTESTINAL PATHOLOGY An Atlas and Text T H I R D E D I T I O N CECILIA M.FENOGLIO-PREISER,MD Director ofGastrointestinal Pathology AmeriPath Arizona Phoenix,Arizona AMY E.NOFFSINGER,MD GRANT N.STEMMERMANN,MD Associate Professor Professor ofPathology University ofChicago University ofCincinnati College ofMedicine Chicago,Illinois Cincinnati,Ohio PATRICK E.LANTZ,MD PETER G.ISAACSON,DM,DSc,FRCPath Associate Professor ofPathology Emeritus Professor Wake Forest University Health Sciences Department ofPathology Winston-Salem,North Carolina Royal Free and University College Medical School London,United Kingdom GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page iv Aptara (PPG-Quark) Acquisitions Editor:Jonathan Pine Managing Editor:Jean McGough Project Manager:Rosanne Hallowell Manufacturing Manager:Kathleen Brown Marketing Manager:Angela Panetta Cover Designer/Design Coordinator:Stephen Druding Production Services:Aptara,Inc. Third Edition © 2008 by Lippincott Williams & Wilkins,a Wolters Kluwer business 530 Walnut Street Philadelphia,PA 19106 LWW.com Second Edition © 1997 by Lippincott Williams & Wilkins First Edition © 1989 by Raven Press All rights reserved.This book is protected by copyright.No part ofthis book may be reproduced in any form or by any means,including photocopying,or utilizing by any information storage and retrieval system without written permission from the copyright owner,except for briefquotations embodied in critical articles and reviews. Printed in China. Library ofCongress Cataloging-in-Publication Data Gastrointestinal pathology :an atlas and text / Cecilia M.Fenoglio-Preiser … [et al.].— 3rd ed. p.;cm. Includes bibliographical references and index. ISBN-13:978-0-7817-7146-7 ISBN-10:0-7817-7146-3 1. Gastrointestinal system—Diseases. 2. Gastrointestinal system—Histopathology. 3. Gastrointestinal system—Diseases—Atlases. 4. Gastrointestinal system—Histopathology— Atlases. I. Fenoglio-Preiser,Cecilia M.,1943– [DNLM: 1. Gastrointestinal Diseases—pathology—Atlases. 2. Gastrointestinal Diseases— pathology. 3. Digestive System—anatomy &histology—Atlases. 4. Digestive System—anatomy &histology.WI140 G2589 2008] RC802.9.G368 2008 616.3'3071—dc22 2007033389 Care has been taken to confirm the accuracy ofthe information presented and to describe generally accepted practices.However,the authors,editors,and publisher are not responsible for errors or omissions or for any consequences from application ofthe information in this book and make no warranty,expressed or implied,with respect to the currency,completeness,or accuracy ofthe contents ofthe publication.Application ofthis information in a particular situation remains the professional responsibility ofthe practitioner. The authors,editors,and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication.However,in view ofongoing research,changes in government regulations,and the constant flow ofinformation relating to drug therapy and drug reactions,the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings.It is the responsibility ofhealth care providers to ascertain the FDA status ofeach drug or device planned for use in their clinical practice. 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Visit Lippincott Williams &Wilkins on the Internet:at LWW.com.Lippincott Williams &Wilkins customer service representatives are available from 8:30 am to 6 pm,EST. 10 9 8 7 6 5 4 3 2 1 GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page v Aptara (PPG-Quark) To Wolf, Rich, Nell, and Kreiter GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page vi Aptara (PPG-Quark) GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page vii Aptara (PPG-Quark) CONTENTS Preface ix Preface totheFirst Edition xi Acknowledgments xiii 1 General Features of the Gastrointestinal Tract and Evaluation of Specimens Derived from It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 The Nonneoplastic Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3 The Neoplastic Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 4 The Nonneoplastic Stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 5 The Neoplastic Stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 6 The Nonneoplastic Small Intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275 7 Epithelial Tumors of the Small Intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471 8 Nonneoplastic Diseases of the Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497 9 The Neoplastic Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 525 10 Motility Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543 11 Inflammatory Bowel Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 593 12 Polyposis and Hereditary Cancer Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . 691 13 The Nonneoplastic Colon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 735 14 Epithelial Neoplasms of the Colon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 899 15 The Nonneoplastic Anus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1037 16 Neoplastic Lesions of the Anus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1067 17 Gastrointestinal Neuroendocrine Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099 18 Lymphoproliferative Disorders of the Gastrointestinal Tract . . . . . . . . . . . . . . . 1161 19 Mesenchymal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1203 Index 1267 vii GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page viii Aptara (PPG-Quark) GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page ix Aptara (PPG-Quark) PREFACE T he third edition ofthis book has been a long time coming about benign and neoplastic gastrointestinal diseases that is not because it has been markedly expanded from the second found in other textbooks.We have tried to arrange the material in a edition.This expansion is the result of suggestions made way that meets the reading or perusing needs of many of you. by you, our readers. It is also the result of an explosion in our Because we believe that “a picture is worth a thousand words,”the understanding ofthe pathophysiology ofmany disorders due to the book is replete with illustrations,diagrams,and tables.As in previous use ofanimal models ofdisease and genetic investigations.Animal editions,we have attempted to incorporate information concerning models have greatly enhanced our understanding ofinflammatory normal anatomy and histology,epidemiology,clinical features,and, bowel disease and motility disorders.Genetic studies have also con- ofcourse,pathologic and prognostic features.We have added abun- tributed to our knowledge ofpredispositions to many types ofneo- dant new genetic information in many areas about both benign and plasms as well as serving as potential prognostic or therapeutic malignant gastrointestinal diseases. The diseases covered include markers.The last decade has also seen an explosion in imaging and those affecting both children and adults. endoscopic diagnostic and therapeutic techniques, which is now Each of the “benign organ”chapters is arranged in a similar generating novel types ofspecimens,including endomucosal resec- way.Each begins with a discussion ofthe normal anatomy and his- tion specimens and increasing numbers of cytologic samples. tology followed by discussions ofcongenital and acquired lesions, During this time our understanding ofmany diseases has expanded, infectious diseases, drug-related diseases, and diseases resulting controversies have arisen,and new entities have emerged. from altered blood flow,as well as many other entities.These chap- Because of the expansion in our knowledge, the size of this ters also contain basic information on the interpretation ofmucosal book would have been unmanageable (and the cost prohibitive) biopsies.We hope that the third edition meets the needs of those without some alterations from the previous edition. Therefore, both in academic centers and in other practice settings.We expect some chapters have been eliminated such as the AIDS and cytology that our readers will continue to find this text helpful in eliminating chapters as well as the separate chapter on the normal anatomy and the need to run to multiple sources to gain a clear understanding of histology ofeach site.This material has been integrated into other gastrointestinal diseases.We hope that the reader finds the abun- chapters. We have also eliminated many radiographs to provide dant illustrations and tables educational. We also hope that this space for additional histologic images or diagrams.One new chap- book is practical for use by both the “generalist”and those practic- ter has been added on endocrine lesions to avoid duplication of ing gastrointestinal pathology.We believe that this book will be use- material and give us more room to add new material.Some chap- ful to pathologists,gastroenterologists,radiologists,internists,and ters have been exhaustively revised,particularly those dealing with surgeons interested in gastrointestinal diseases, whether they be gastrointestinal stromal tumors,gastrointestinal hematologic dis- clinicians,clinician educators,or researchers. eases,and motility disorders.We have also added in material that was on the CD that went with the second edition but was not in the Cecilia M.Fenoglio-Preiser,MD printed version ofthe book. Amy E.Noffsinger,MD We intend for this work to be comprehensive and helpful for Grant N.Stemmermann,MD those dealing with biopsies as well as cytology and resection speci- Patrick E.Lantz,MD mens ofall gastrointestinal sites,and it therefore contains information Peter G.Isaacson,DM,DSc,FRCPath ix GRBQ314-3367G-FM[i-xvi].qxd 9/17/07 07:05 PM Page x Aptara (PPG-Quark)
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