Serra, Stefano / Ali, Rola / Bateman, Adrian C / Dasgupta, Kaushik / Deshpande, Vikram / Driman, David K / Gibbons, David / Grin, Andrea / Hafezi-Bakhtiari, Sara / Sheahan, Kieran / Srivastava, Amitabh / Szentgyorgyi, Eva / Vajpeyi, Rajkumar / Walsh, Shaun / Wang, Lai Mun / Chetty, Runjan. ·Department of Pathology, University Health Network/University of Toronto, Canada. Electronic address: Stefano.serra@uhn.ca. · Department of Pathology, Kuwait University, Kuwait. · Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK. · Department of Pathology, University Hospital of North Tees, UK. · Massachusetts General Hospital, Boston, USA. · Department of Pathology, London Health Sciences Centre/Western University, Canada. · Department of Pathology, St Luke's Hospital, Dublin, Ireland. · Department of Pathology, St Michael's Hospital, Toronto, Canada. · Department of Pathology, University Health Network/University of Toronto, Canada. · Department of Pathology, St Vincent's University Hospital, Dublin, Ireland. · Brigham and Women's Hospital, Boston, USA. · Department of Pathology, Ninewells Hospital, Dundee, UK. · Department of Pathology, Oxford University Hospitals Trust, Oxford, UK. ·Pathology · Pubmed #28438394.

ABSTRACT: This study aimed to ascertain views, incidence of reporting and diagnostic criteria for gastric foveolar dysplasia. A questionnaire, a post-questionnaire discussion and microscopic assessment of selected cases was conducted by gastrointestinal pathologists to explore the above-stated aims. Fifty-four percent of respondents never or rarely diagnosed gastric foveolar-type dysplasia. The general consensus was that round nuclei, lack of nuclear stratification, presence of inflammation/damage and surface maturation favoured reactive change; while architectural abnormalities/complexity and nuclear enlargement mainly were used to separate low-grade from high-grade foveolar dysplasia. Immunohistochemistry was rarely used to make the diagnosis of dysplasia and was thought not to be of help in routine practice. Inter-observer agreement in grading of dysplasia versus reactive, and the type of dysplasia (foveolar versus adenomatous), was substantial/almost perfect amongst 35.7% and 21.4% of participants, respectively. This reflects low reproducibility in making these diagnoses. In conclusion, foveolar dysplasia was a rarely made diagnosis among 14 gastrointestinal pathologists, there are no uniform criteria for diagnosis and there is poor inter-observer agreement in separating low-grade foveolar dysplasia from reactive gastric mucosa and low-grade adenomatous dysplasia. Greater awareness and agreed criteria will prevent misdiagnosis of low-grade foveolar dysplasia as reactive, and vice versa.