System : Digestive tract
Introduction
This subspeciality includes a broad spectrum of inflammatory and tumoral pathology (benign and malignant tumors) of different organs (liver, pancreas, esophagus, stomach, small bowel, large bowel and anus).
Diagnosis of common pathologies such as gastritis are easy to make but other diagnoses are more difficult for general pathologists such as liver diseases or dysplasia. Moreover, different scoring systems, that are constantly evolving, are used for inflammatory disease.
For cancerous diseases, specific and increasingly complex classifications applied (TNM, WHO and/or specific classifications for some tumors) and various biomarkers are needed, including molecular or immunohistochemistry features
Why refer cases for a second opinion ?
A second opinion can improve diagnosis for tumor pathologies, particularly for CUPs (carcinoma of unknown primary sites ) or rare tumors. Diagnostic accuracy is now crucial, particularly in the current era of targeted molecular and immune-based therapies.
Therapeutic management of chronic inflammatory diseases such as Barret esophagus or inflammatory bowel diseases are based on histopathological criteria and several European or American guidelines require a second opinion for some critical markers such as dysplasia.
