De Petris G, De Marco L, López J I
Department of Pathology, Penrose-St. Francis Hospital, Colorado Springs, CO USA.
Anatomia Patologica, Arcispedale Santa Maria Nuova, Reggio Emilia (RE), Italy.
Pathologica. 2017 Jun;109(2):97-109.
The goals of this short narrative review are 1) to provide an update in recent developments in the field of drug-induced gastrointestinal injury (DIGI), and 2) to distill few key points to approach with confidence a difficult and vast area of gastrointestinal pathology. DIGI is a challenging diagnosis as it can produce almost any pattern of the injury of the gastrointestinal tract. The recognition of a pattern and the knowledge of which drugs can produce that pattern, are the first step of the diagnostic process; communication with the clinical team and a high level of suspicion are then paramount. The pathologist can be the leading clinicians of the care team in few situations in which she/he can recognize the drug at the microscope. Knowledge of the most relevant differential diagnoses of DIGI is essential to avoid significant pitfalls. Finally, several DIGIs due to recently developed immunomodulators used in oncology have shown relevance given their sometimes fatal outcome and the accumulating evidence of a common morphological appearance among them.
1）介绍药物性胃肠损伤（DIGI）领域的最新进展；2）提炼几个关键点，以便有信心地应对胃肠病理学这一困难且广泛的领域。DIGI是一种具有挑战性的诊断，因为它几乎可以产生胃肠道损伤的任何模式。识别损伤模式以及了解哪些药物可导致该模式，是诊断过程的第一步；随后与临床团队沟通并保持高度怀疑至关重要。在少数情况下，病理学家在显微镜下能够识别药物时，可成为护理团队的主导临床医生。了解DIGI最相关的鉴别诊断对于避免重大失误至关重要。最后，由于肿瘤学中使用的一些最新开发的免疫调节剂导致的几种DIGI已显示出相关性，因为它们有时会导致致命后果，且越来越多的证据表明它们具有共同的形态学表现。
