WSI22-23: Gastrointestinal didactic - Wednesday, October 19, 2022

From MGH Learn Pathology


Request type AP didactic (409073007) - MGH
Subspecialty Gastrointestinal
Topic GI
Presenter Mino-Kenudson, Mari,MD
Date and time Wednesday, October 19, 2022 1:00 PM



Case Clinical history Requester
Case Clinical history Requester

Case 1


A 70-year-old woman with pseudogout underwent upper GI endoscopy for iron deficiency anemia and was found to have patchy plaques 2-4 cm in length and 2 cm across in the gastric antrum that did not scrape off. Kx601

Case 2


A 64-year-old man presented with melena. Upper GI endoscopy showed an ulcerated mass-like lesion in the antrum. Mm768

Case 3


A 34-year-old woman with end stage kidney disease on dialysis presented with refractory nausea and vomiting and was found to have patchy moderate inflammation with edema erythema and granularity in the gastric body. Mm768

Case 4


A 52-year-old man with metastatic intrahepatic cholangiocarcinoma presented with abdominal pain nausea vomiting and poor oral intake and upper GI endoscopy found gastric ulcer in the prepyloric region and nodular mucosa in the pylorus of the stomach. Mm768

Case 5


A 30-year-old woman with generalized abdominal distress/pain and dyspepsia; r/o celiac disease Mm768

Case 6


A 66-year-old woman with a history of gout presented with chronic cough vomiting and weight loss. Mm768

Case 7


A 70-year-old woman with hypertension presented with chronic diarrhea and weight loss. Endoscopic examination showed mild mucosal nodularity in the small intestine. Mm768

Case 8


A 70-year-old woman with cutaneous T cell lymphoma s/p bone marrow transplant (BMT) presented with diarrhea. Mm768

Case 9


A 46-year-old woman with a history of Loeys-Dietz syndrome and post cardiac transplant presented with diarrhea abdominal pain and poor oral intake. Mm768

Case 10


A 65-year-old man with chronic lymphocytic leukemia presented with moderately severe continuous non-bloody diarrhea not responding to antimotility agents. Mm768

Case 11


A 70-yea-old man with stage IV malignant melanoma on ipilimumab presented with diarrhea. Mm768

Case 12


A 70-year-old woman with stage IV melanoma on nivolumab after progression on ipilimumab Mm768

Case 13


A 52-year-old man with metastatic squamous cell carcinoma of the tongue presented with several episodes of diarrhea per day. A: random colon B: rectum Mm768

Case 14


A 55-year-old man with Melanoma on anti-PD-1/CTLA-4 combination developed diarrhea and abdominal pain. Clinical work-up showed an elevated tTG IgA titer (121 IU/mL). Mm768

Case 15


A 67-year-old man with a suspected mass in rectum seen on MRI Mm768

Case 16


A 91-year-old woman with perforated diverticulitis and abscess formation Mm768

Case 17


A 73-year-old woman with chronic diarrhea r/o microscopic colitis Mm768

Case 18


A 57-year-old woman with a white spot found in the left colon during screening colonoscopy Mm768

Case 19


A 67-year-old woman presented with left sided abdominal pain radiating to the left chest for a week and was found to have a 2.5 cm mass lesion in the pancreatic body with upstream pancreatic ductal dilatation. Mm768

Case 20


A 79-year-old man presented with back pain. Work-up showed markedly heterogeneous appearance of the liver which appears to be replaced by numerous hypodense masses and a heterogeneous mass in the neck of the pancreas depicted by CT scan. Mm768

Case 21


A 38-year-old woman with an incidentally discovered 4 cm mass in the pancreas Mm768

Case 22


A 11-year-old woman with a 5 cm heterogenous mass incidentally discovered after complicated appendicitis Mm768

Case 23


A 82-year-old man with history of recurrent pancreatitis presented with symptoms of acute pancreatitis and was found to have a cystic mass with the main pancreatic duct dilatation in the pancreatic head during work-up. Mm768

Case 24


A 71-year-old man with an incidentally discovered 6.7 x 2.7 cm multi-cystic mass in the head of the pancreas Mm768

Case 25


A 70-year-old man with a multicystic mass with regions of mural soft tissue nodularity throughout the pancreas Mm768

Case 26


A 70-year-old man developed oily stools and was found to have pancreatic insufficiency several months ago. Further work-up identified a 4.0 cm segment of very irregular pancreatic duct with filling defects consistent with intraductal papillary tumors and/or mucous and a prominently dilated pancreatic duct to near 1.0 cm in the diameter in the body and tail of the pancreas without evidence of irregularity there. Mm768

Case 27


A 71-year-old woman with a cyst in the body and tail the pancreas measuring 16 cm in maximal diameter Mm768

Case 28


A 75-year-old woman with a multi-septated low attenuation cyst in the head of the pancreas that has grown from 5 cm to 15 cm in size for 6 years. Mm768

Case 29


A 52-year-old woman with past medical history notable for Von Hippel Lindau (VHL) syndrome with multiple left renal cell carcinomas s/p left radical nephrectomy and right renal cell carcinoma s/p right partial nephrectomy presented for surgical evaluation in the setting of multiple pancreatic cysts and recently discovered pancreatic body mass. Mm768

Case 30


A 35-year-old woman with an incidentally discovered 4 cm cyst in the distal pancreas Mm768

Case 31


A 63-year-old man with an incidentally found a 4 cm pancreatic tail cyst Mm768

Case 32


A 19-year-old woman with an incidentally found cystic lesion in the tail of pancreas Mm768

Case 33


A 20-year-old woman presented with abdominal pain related to menstrual cycle and was found to have a 4 cm cyst in the pancreatic tail on imaging. Mm768

Case 34


A 81-year-old woman developed abdominal pain vomiting and diarrhea a month before the operation and was found to have elevated liver enzymes (a total bilirubin of 2.6 alkaline phosphatase of 506 ALT 493 and AST. Mm768

Case 35


A 53-year-old male with an incidental finding of a potentially early pancreatic cancer in the pancreatic body Mm768

Case 36


A 57-year-old woman with alcohol abuse in the past presented with recurrent episodes of pancreatitis and was found to have a 4 cm mass involving the head of the pancreas. Mm768