title: Colorectal stents orient specimens and induce artifacts that mimic Crohn disease.
abstract: Colorectal malignancies may be stented to alleviate obstruction. The stent is a polarized and braided network of metallic wires. Pathology associated with colorectal stents is yet to be described. The authors reviewed 7 cases involving stented colorectal segments from patients lacking clinical suspicion of Crohn disease. In 4 cases, orientation of the specimens and stents matched the corresponding anatomic landmarks. In 3 cases, the specimens lacked helpful anatomic landmarks, and orientation was possible only after correlating with the intrinsic polarity of the stents. Stented areas showed artifacts resembling Crohn disease, including rounded cobblestones, pseudopolyps, and simple fissures, as well as unique artifacts including rhomboid cobblestones, complex fissures, oblique fissures with remarkably straight edges, and conical fragments of tissue that appeared to float. Crohn disease was misdiagnosed in 1 case in which the stent was removed intraoperatively and was never received. Colorectal stents help orient ambiguous specimens and induce patterned injury that can be confused with Crohn disease.
authors.affiliation: University of California-Irvine, Irvine, CA, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Amini
authors.forename: Dana
authors.initials: D
authors.lastname: Haydel
authors.forename: Niloufar
authors.initials: N
authors.lastname: Reisian
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Sempa
authors.forename: Julia
authors.initials: J
authors.lastname: Chu
authors.forename: Qun
authors.initials: Q
authors.lastname: Wang
authors.forename: Guohua
authors.initials: G
authors.lastname: Zhao
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
authors.forename: Mark Li-cheng
authors.initials: ML
authors.lastname: Wu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D016477:Artifacts; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003424:Crohn Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D013048:Specimen Handling / Q000379:methods*; D015607:Stents