ECP 2023 Abstracts

S215 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 nodules in asymptomatic patients, as they can indicate a widespread systemic disease and a poorer prognosis. E-PS-06-087 Massive intestinal bleeding in a patient with AL-amyloidosis ini- tially diagnosed as multiple vascular malformation O. Vasyukova*, Z. Gioeva, L. Mikhaleva, R. Vandysheva, K. Midiber, N. Gutyrchik, V. Pechnikova, A. Birukov, D. Areshidze, M. Kozlova *AvtsynResearch Institute of HumanMorphology of Federal State Budgetary Scientific Institution "PetrovskyNational ResearchCentre of Surgery", Russia Background & objectives: Intestinal amyloidosis symptoms may mimic different digestive tract disorders which makes the diagnosis quite challenging. Objective: to present a clinical case of Al-amyloi- dosis in patient with recurrent intestinal bleeding, initially assessed as multiple vascular malformations of the small intestine. Methods: 60-year-old female patient was admitted to the surgery depart- ment complaining of blood in the stool and extreme fatigue. Esophagogas- troduodenoscopy did not reveal the source of bleeding. The colonoscopy results suggested that the bleeding could come from the small intestine, since there were no findings in the colon. The ileal resection and the ileo-ascending anastomosis was performed due to continuous bleeding. Results: Pathological examination of the resected sample demonstrated multiple vascular malformations of the small intestine. The bleeding stopped after the surgical procedure, the patient’s condition significantly improved, and she was discharged from the hospital for outpatient fol- low-up. However, 4 months later the bleeding recurred. The patient underwent gastrointestinal endoscopy which revealed mucosal haemor- rhage sites and high-density tumour-like lesions in the small intestine. Lesions’ biopsy results revealed AL-amyloidosis. Previous histological slides from the surgery were reviewed, and massive perivascular and interstitial amyloid deposits were found. Earlier these findings were interpreted as severe angiomatosis lesions with extensive haemorrhagic areas, leading to misdiagnosis and delayed appropriate treatment. Conclusion: It should be kept in mind that surgical patients with mas- sive bleeding of unknown cause from the small intestine may have amyloidosis. This disease is considered one of the causes of massive recurrent bleedings resulting from amyloid deposition within the blood vessel walls of the small intestine. Funding: This study was supported by RSF, grant No. 23-15-00138. E-PS-06-088 Histopathological clues for common variable immunodeficiency disorder (CVID) in a patient initially presenting with inflammatory bowel disease (IBD): case report and literature review L. Velthof*, J. Geldof, J. Van Dorpe, T. Lobaton, A. Hoorens *Ghent University Hospital (UZ Gent), Department of Pathology, Belgium Background & objectives: Gastrointestinal manifestations are a major cause of morbidity in CVID and mimic IBD in 6% to 10% of patients. Diagnosis remains challenging and is often delayed, potentially result- ing in life-threatening complications, hence the importance of early recognition. Methods: We present a case of a 61-year-old man, initially diagnosed with Crohn’s disease at age 33 and later found to have CVID at age 52. We reviewed all gastrointestinal biopsies and conducted an extensive literature review in search of histopathological clues that may contrib- ute to the diagnosis of CVID when both clinical symptoms and biopsy findings are suggestive of IBD. Results: Review of gastrointestinal biopsies and correlation with lit- erature findings revealed histopathological features that are atypical of IBD and may indicate CVID. These features include an increase in intraepithelial lymphocytes, thickening of the subepithelial collagen layer, an increase in crypt apoptotic bodies and a relative paucity of plasma cells. However, these findings can be subtle and can easily go unnoticed if not carefully searched for. Better recognition of these his- topathological indications of CVID may contribute to earlier diagnosis and treatment, thereby avoiding potentially life-threatening complica- tions such as infections or malignancies. Conclusion: CVID is the most common primary immunodeficiency following selective IgA deficiency and is the most important sympto- matic primary immunodeficiency. Clinical manifestations are heterog- enous and include infections, autoimmunity, gastrointestinal disease and malignancies. Gastrointestinal manifestations occur in up to 60% of patients and often mimic other gastrointestinal conditions such as celiac disease, Whipple’s disease, microscopic colitis, graft-versus- host disease or IBD. This case report and literature review highlights histopathological clues for CVID in the gastrointestinal tract and aims to raise awareness of CVID. E-PS-06-089 Immunohistochemical analysis of metastasis-associated protein 1 (mta-1), cyclin d1 and cd44 expression in gastric adenocarcino- mas and evaluation of their relationship with clinicopathological prognostic factors A. Vergili*, N. Ekinci *Izmir Katip Celebi University, Ataturk Training and Research Hospi- tal, Department of Pathology, Turkey Background & objectives: Gastric adenocarcinoma is a common and deadly malignancy, with a poor prognosis and limited therapeutic options. In this study, we aimed to investigate MTA-1, Cyclin D1, and CD44 immunoexpressions in gastric adenocarcinomas and evaluate their relationship with clinicopathological prognostic parameters. Methods: 80 patients who underwent radical gastrectomy and were diagnosed with gastric adenocarcinoma in our hospital in 2017 and 2018 were compiled. Immunohistochemically MTA-1, Cyclin D1 and CD44 stains were applied to appropriate tumour blocks and evaluated according to staining intensity and percentage. Immunohistochemi- cal staining and histopathological prognostic data in those tumours were evaluated statistically and p<0.05 was considered statistically significant. Results: Of the 80 patients included in the study, 54 were male and 26 were female. While 73 patients had pure adenocarcinoma, 7 had mixed carcinoma. T3 stage was the most common T stage of the patients (45%). Lymph node metastasis was observed in 66%, and distant metas- tasis in 2.5% of the patients. Lymphovascular invasion (LVI) was found in 70% of cases and perineural invasion (PNI) was observed in 57% of the cases. A significant correlation was found between Cyclin D1 expression and T-stage and PNI. Also, CD44 expression was correlated with N stage, LVI and PNI. Finally, a significant correlation was found between MTA-1 expression and PNI. Conclusion: Gastric adenocarcinoma has a poor prognosis and it is the 3rd most common reason of cancer related deaths worldwide. As we found in our study, most patients present with advanced stage. Cyclin D1, CD44 and MTA-1 have pathogenetic roles in various cancers and our study showed that they are related with poor prognosis. According to our results, we think that the use of these markers in gastric carcino- mas may be useful to predict prognosis and possible future treatment options. E-PS-06-090 Vascular lesions of the gastrointestinal system: a case series of 25 patients A. Vergili*, N. Ekinci, A. Avci *Izmir Katip Celebi University, Ataturk Training and Research Hospital, Department of Pathology, Turkey Background & objectives: Arteriovenous malformation, angiodys- plasia, and haemangioma are used to describe vascular lesions of the