TY - JOUR
T1 - New kids on the block
T2 - A review of the latest iatrogenic foreign materials seen in gastrointestinal specimens
AU - Karamchandani, Dipti M.
AU - Hammad, Hazed
AU - Chetty, Runjan
AU - Arnold, Christina A.
N1 - Publisher Copyright:
© 2021 College of American Pathologists. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Context.-With the increasing development and use of iatrogenic agents, pathologists are encountering more novel foreign materials in retrieved gastrointestinal specimens. These colorful and unusual-appearing foreign materials can pose a diagnostic dilemma to those unaware of their morphology, especially if the relevant clinical history is lacking. Objective.-To discuss the histopathologic features, clinical scenarios and significance, and differential diagnosis of relatively recently described, yet quickly expanding, family of iatrogenic agents that can present as foreign materials in gastrointestinal specimens-pharmaceutical fillers (crospovidone and microcrystalline cellulose), submucosal lifting agents (Eleview and ORISE), lanthanum carbonate, hydrophilic polymers, OsmoPrep, yttrium 90 microspheres (SIR-Sphere and TheraSphere), and resins (sodium polystyrene sulfonate, sevelamer, and bile acid sequestrants). Data Sources.-We collate the findings of published literature, including recently published research papers, and authors' personal experiences from clinical sign-out and consult cases. Conclusions.-Correct identification of these iatrogenic agents is important because the presence of some novel agents can explain the histopathologic findings seen in the background specimen, and specific novel agents can serve as diagnostic clues to prompt the pathologist to consider other important and related diagnoses. Awareness of even biologically inert agents is important for accurate diagnosis and to avoid unnecessary and expensive diagnostic studies.
AB - Context.-With the increasing development and use of iatrogenic agents, pathologists are encountering more novel foreign materials in retrieved gastrointestinal specimens. These colorful and unusual-appearing foreign materials can pose a diagnostic dilemma to those unaware of their morphology, especially if the relevant clinical history is lacking. Objective.-To discuss the histopathologic features, clinical scenarios and significance, and differential diagnosis of relatively recently described, yet quickly expanding, family of iatrogenic agents that can present as foreign materials in gastrointestinal specimens-pharmaceutical fillers (crospovidone and microcrystalline cellulose), submucosal lifting agents (Eleview and ORISE), lanthanum carbonate, hydrophilic polymers, OsmoPrep, yttrium 90 microspheres (SIR-Sphere and TheraSphere), and resins (sodium polystyrene sulfonate, sevelamer, and bile acid sequestrants). Data Sources.-We collate the findings of published literature, including recently published research papers, and authors' personal experiences from clinical sign-out and consult cases. Conclusions.-Correct identification of these iatrogenic agents is important because the presence of some novel agents can explain the histopathologic findings seen in the background specimen, and specific novel agents can serve as diagnostic clues to prompt the pathologist to consider other important and related diagnoses. Awareness of even biologically inert agents is important for accurate diagnosis and to avoid unnecessary and expensive diagnostic studies.
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U2 - 10.5858/arpa.2020-0535-RA
DO - 10.5858/arpa.2020-0535-RA
M3 - Article
C2 - 33571357
AN - SCOPUS:85116243656
SN - 0003-9985
VL - 145
SP - 1569
EP - 1584
JO - Archives of Pathology and Laboratory Medicine
JF - Archives of Pathology and Laboratory Medicine
IS - 12
ER -