Search

Objective: Cholecystectomy materials are frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria. Material and Method:14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined. Results: A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered. Conclusion: In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.

Objective In Barrett’s oesophagus (BE), after radiofrequency ablation (RFA), the oesophagus can be repopulated with a stratified ‘neosquamous epithelium’ (NeoSE). While histologically normal, the origin and clonal make-up of this NeoSE is unknown. An increased understanding of NeoSE is important as some studies suggest that NeoSE is biologically abnormal. The aim of this study was to determine whether there were major differences in the mutational landscape or clonal size in NeoSE versus normal squamous epithelium and determine whether NeoSE shares any pathogenic mutations with BE.Methods and analysis 10 patients who underwent RFA and 10 samples from 8 control patients were sequenced using a clinical targeted sequencing platform (cohort 1). An additional, eight patients with paired preablation BE and postablation NeoSE were also sequenced (cohort 2). Patient advocates will be used to disseminate the findings of this study.Results NeoSE samples had a mean of 2.2 pathogenic mutations per sample, including 50% of samples with an NOTCH1 and 30% of samples with a TP53 mutation. The normal oesophagus samples had 1.5 mutations per sample, including 40% of samples with NOTCH1 and 10% of samples with TP53 mutations. There was no difference in mutational allele fractions between NeoSE and normal squamous samples. When we compared paired BE and NeoSE samples, no shared mutations were identified.Conclusion While there was a trend for more TP53 mutations in NeoSE, overall, the mutational profile and clonal sizes (allele fractions) were very similar, suggesting NeoSE is genomically similar to the normal oesophageal squamous epithelium.