ECP 2022 Abstract Book

Vol.:(0123456789) 13 Virchows Archiv https://doi.org/10.1007/s00428-022-03379-4 ABSTRACTS 34 th European Congress of Pathology - Abstracts © Springer-Verlag GmbH Germany, part of Springer Nature 2022 Oral Free Paper Sessions OFP-01 | Oral Free Paper Session Digestive Diseases Pathology - GI OFP-01-001 Gastric polyps in familial adenomatous polyposis (FAP) Por- tuguese patients - the first Western cohort with Asian features D. Baptista*, M. Fernandes, F. Sousa, M. Garrido, L. Pinho, R. Morais, M. Baptista, F. Carneiro, I. Gullo * Pathology Department, Centro Hospitalar Universitário de São João (CHUSJ), Portugal Background & objectives: Chronic atrophic gastritis may con- tribute to the phenotype of gastric polyps in familial adenomatous polyposis (FAP). As the prevalence of Helicobacter-pylori infection in Portugal is up to 90%, we aim to characterize gastric polyps in a series of Portuguese patients. Methods: Fifty-six FAP patients followed up at our hospital in High-Risk Consultation of Digestive Tumours, from 1992 to 2021 were retrospectively selected. Thirty-two patients were males (57.1%), and the medium age was 52 (range: 26-87). Clinico- pathological features, with particular emphasis on periodic upper endoscopic examinations, were studied. IBM SPSS (Release 27.0) was used for statistical analysis. Results: Our series encompassed 95 gastric polyps, includ- ing 53 (55.8%) fundic gland polyps (FGPs) without dysplasia (n=34) or with dysplasia (n=19) and 42 (44.2%) intestinal- type adenomas. Half of FAP patients (n=28, 50.0%) devel- oped endoscopically visible gastric polyps, including FGPs in 12 patients (21.4%) and adenomas with or without FGPs in 16 patients (28.6%). Foveolar-type adenomas and pyloric gland adenomas were not identified in this series. Intestinal- type adenomas occurred predominantly in the distal stomach (62.5%, p=0.031), were larger than 7mm in 9/16 cases (56.3%, p=0.03), and were more frequently associated with duodenal adenomas (87.5%, p<0.001). Chronic atrophic gastritis and intestinal metaplasia was observed in the background mucosa in most cases (75.0%, p=0.009). Conclusion: To our knowledge, this is the first Western series showing high prevalence of intestinal-type adenomas in FAP patients, comparable to Asian studies. Chronic atrophic gastri- tis/intestinal metaplasia are likely responsible for this differ- ence, with risk of neoplastic transformation and management implications. Endoscopists should have a high degree of sus- picion in FAP patients and low threshold to biopsy/excision of gastric polyps, particularly in patients with chronic atrophic gastritis/intestinal metaplasia, in those with distal gastric pol- yps with worrisome features (namely >7mm) and/or duodenal adenomas. OFP-01-002 Road-mapping for gastric intestinal metaplasia E.K. Çagdas*, İ. Adanır, C. Ersöz, Ş. Ersöz, B. Savaş, A. Ensari *Ankara University School of Med., Turkey Background & objectives: Uneven distribution of gastric intes- tinal metaplasia (GIM) may require mapping biopsies rather than random biopsies which may fail to reflect the extent of the lesions. We, hereby, evaluated the value of mapping in determining the extent and severity of IM. Methods: Random biopsies (RB) obtained according to updated Sydney protocol and mapping biopsies (MB) taken from 6 differ- ent sites of corpus and antrum during surveillance were evaluated for the severity and extent of histologic parameters of gastritis, mainly focusing on GIM with atrophy in a cohort of 202 patients. Statistical analysis was performed using Wilcoxon test on SPSS version 22. Results: Mean age of 202 patients (104 females, 86 males) was 61.78±11,5 years. Average time interval between RB and MB was 18 months. There were 98 cases with isolated antral IM and 75 cases with isolated corpus IM in RB while MB revealed IM in the cor- pus in 13 of 98 cases (13.26%) and antral IM in 23 of 75 (30.66%) cases. IM at both sites was observed in 17 (8.9%) RB and 31 (16.4%) MB which yielded a significant increase by an increment of 1.84 (p<0.05). Severity of antral IM significantly increased in MB in 28% of cases (p<0.05) while no such difference was found for corpus IM. Conclusion: The results of the present study suggest that mapping with multiple biopsies improves the detection rate of IM both in the corpus and antrum, providing information for the extent and sever- ity of the lesions. This approach also seems to be useful in cases with isolated antral IM in monitoring severity of IM as already dem- onstrated by MB taken from the antrum in our study. However, large prospective, randomized, multicentre studies comparing different follow-up strategies are necessary for a better roadmap. OFP-01-003 Myths and facts: ref lux oesophagitis vs eosinophilic oesophagitis E.K. Çagdas*, N. Aras, C. Ersöz, Ş. Ersöz, Z. Kuloglu, A. Kansu Tanca, B. Savaş, A. Ensari *Ankara University School of Med., Turkey Background & objectives: Basal cell hyperplasia and papilloma- tosis are non- discriminatory for eosinophilic oesophagitis (EoO) or reflux oesophagitis (RO). The aim here is to clarify the true incidence of these features in RO and EoO using morphometry to highlight their diagnostic significance. (2022) 481 (Suppl 1):S1–S364 Published online: 16 August 2022