The Caris Dx Difference

GI and pathology subspecialists partnering to produce academic-caliber diagnoses

GI clinicians know that their endoscopic expertise and subspecialty focus is critical to the delivery of optimal patient care. The same is true for subspecialized GI pathologists; their expertise is critical, not only for esoteric cases, but for routine cases as well. At Caris Diagnostics, our pathologists consistently prove that subspecialty expertise adds value everyday by:

• Recognizing the effect of medications
• Identifying subtle histologic diagnoses
• Recognizing that some innocuous processes mimic IBD
• Correctly classifying inflammatory conditions
• Accurately grading dysplasia and recognizing the absence of dysplasia
  • Minimize ‘indefinite’ diagnoses
• Accurately classifying polyps, including:

• Malignant polyps
• Newly recognized entities, such as sessile serrated adenomas
• Diagnosing normal as ‘normal’

Daily multi-headed microscope consensus conference   With over 10,000 GI specimens seen each week, our team of academic-caliber pathologists benefit from an abundance of interesting cases and the experience of veteran GI pathologists.

 

Our Diagnosis:

• Active duodenitis with reactive epithelial atypia, consistent with chemotherapy effect.
• No dysplasia or malignancy is present.

The CarisDx Difference

• No confusion as to whether the patient has a malignant process (primary or metastatic) involving the duodenum.
• No dysplasia or malignancy is present.

 

Our Diagnosis:

• Lymphocytic Colitis.

The CarisDx Difference

• Patient’s outside slides were requested and reviewed
• Our opinion that these outside biopsies (incorrectly interpreted as ‘Ulcerative colitis’)
  also represented Lymphocytic Colitis
• Avoidance of complications related to immunosuppressive therapy
• Allows for appropriate therapy for lymphocytic colitis
• No need for continuance of lifetime colonic surveillance

 

Outside Diagnosis:

• Active Ileitis with Ulceration, Hemorrhage, and Granulation Tissue.
• Comment refers to the possibilities of Ischemia, Infection, Drug-induced Ileitis, and Crohn’s Disease.
• Gastroenterologist asks Caris Dx for consultation due to confusion on how to treat and further evaluate.

Our Diagnosis:

• Active ileitis with fissuring ulcers and transmural inflammation, most consistent with Crohn’s disease.
• Clinician notified that the patient has Crohn's disease, not infection or ischemia.

The CarisDx Difference

• Specific diagnosis rendered
• No additional diagnostic work-up for ischemia is necessary
• Allows for immediate and effective therapy
• No concern about giving immunosuppressive therapy to a patient with an infectious process

 

Our Diagnosis:

• Benign Anorectal Mucosa with Evidence of Trauma/Prolapse.

The CarisDx Difference

• Findings suggestive of IBD; however, case reviewed at daily conference and determined to represent
  only trauma /prolapse changes. Patient was not labeled with chronic colitis/proctitis
• Inappropriate treatment with immunosuppressive agents was avoided

 

Our Diagnosis:

• Absent Plasma Cells, Consistent with an Immunodeficiency Disorder.

Clinician Contacted:

• Patient later confirmed to be IgA deficient.

The CarisDx Difference

• Identification of a potentially treatable condition
• Likely to have been considered ‘normal’ by general pathologists
• Extremely subtle features recognized that may explain diarrhea, malabsorption, sinopulmonary disease or bacterial infections
• Information may prevent a reaction to a future blood transfusion

 

Our Diagnosis:

• Colonic Spirochetosis.

The CarisDx Difference

• Provides a reasonable explanation for this patient’s diarrhea and weight loss (spirochetosis can also cause rectal
  bleeding, abdominal pain, purulent discharge, and an appendicitis-like picture)
• Avoidance of complications related to immunosuppressive therapy
• Identifies a condition that may respond to antibiotic therapy
• Recognition of a subtle finding that may be easily overlooked

 

Our Diagnosis

• Sessile Serrated Adenoma.

The CarisDx Difference

• Recognizing that many bland polyps previously thought to be hyperplastic polyps are actually pre-malignant lesions
• Understanding the difference between:
• Large hyperplastic polyps
• Traumatized hyperplastic polyps
• Mixed hyperplastic-adenomatous polyps
• 'Traditional' serrated adenomas
• Sessile serrated adenomas
• Sessile serrated adenomas with dysplasia or carcinoma
• Seeing over 2000 biopsies / day with 26 expert GI pathologists convening daily to discern subtle cases maximizes the specifitity of diagnoses
• Including newly identified lesions, such as sessile serrated adenomas, that may explain so-called interval cancers.