STEPHEN LAGANA, M.D.

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This study focused on eosinophilic esophagitis (EoE), a chronic disease that can lead to serious complications in the esophagus. Researchers developed an artificial intelligence (AI) tool to measure a specific type of tissue scarring called lamina propria fibrosis (LPF) using routine biopsy slides. They found that the AI scores accurately predicted the development of strictures and other complications in patients over an average follow-up of 31 months, even with small biopsy samples. Who this helps: This benefits both patients and doctors by improving the early detection of severe complications in EoE.

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This study examined three patients who developed celiac disease after starting new immune-modulating medications for conditions like psoriasis, breast cancer, and kidney cancer. Specifically, a 21-year-old woman, a 49-year-old woman, and an 82-year-old man all experienced celiac disease symptoms after their treatments. It’s crucial for doctors to recognize celiac disease in patients starting these therapies because it can change how their healthcare is managed, potentially avoiding unnecessary treatments. Who this helps: This helps patients undergoing immunotherapy treatments.

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This study looked at a specific pattern of cancer spread called "pagetoid spread" in patients with esophageal squamous cell carcinoma (ESCC). Researchers found seven cases of this type of spread among ESCC patients, indicating it is more common than previously documented, with patient ages ranging from 54 to 78 years. The findings are important because they help doctors recognize and diagnose this condition more accurately, which can impact treatment decisions and patient outcomes. Who this helps: This helps patients and doctors involved in diagnosing and treating esophageal cancer.

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This study looked at lymph nodes (LNs) in untreated colorectal cancer (CRC) cases that contained only acellular mucin, which usually means there is no cancer spread. Researchers analyzed 63 cases from the U.S. and 23 from the Netherlands and found that these cases had better outcomes, with none of the patients dying from CRC, unlike a control group that had a higher risk of CRC-related death. This is important because it suggests that lymph nodes with only acellular mucin in untreated CRC can safely be considered cancer-free, which can impact treatment decisions. Who this helps: Patients with untreated colorectal cancer.

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This study looked at how certain bile acids in the stomach affect the bacteria living in the esophagus and gene activity in patients with Barrett's esophagus, a condition that can lead to esophageal cancer. Researchers analyzed samples from 153 patients and found that those with Barrett's esophagus had higher levels of specific bile acids, which were linked to changes in their bacteria and gene expression. This is important because understanding these connections could help in developing better treatments or prevention strategies for esophageal cancer. Who this helps: This research benefits patients with Barrett's esophagus and doctors treating them.

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This study focused on a young woman diagnosed with a rare type of cancer called lymphoepithelioma-like carcinoma, believed to originate from the small intestine. The cancer had spread to her liver and lymph nodes and was linked to the Epstein-Barr virus; despite initially responding to treatment, her condition worsened quickly. Understanding this rare cancer is important because it affects how doctors approach treatment and care for similar cases in the future. Who this helps: This helps patients with rare cancers and their healthcare providers.

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This study looked at the effectiveness of taking extra liver samples during surgery for children with biliary atresia when they had already had a needle biopsy before surgery. Researchers reviewed data from 116 patients and found that in 34.5% of cases, the results from the two types of biopsies did not match, with the additional biopsies often indicating worse liver damage. Overall, the type of biopsy did not show a clear link to how well the liver functioned a year after surgery, but younger age and lower liver enzyme levels were connected to better survival outcomes. Who this helps: This information helps pediatric surgeons and doctors providing care to children with biliary atresia.

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This study looked at a protein called CLDN18 in bile duct cancer, or cholangiocarcinoma, to see if it might be a target for new treatments. They found that about 13% of bile duct cancers showed high levels of this protein, similar to other cancers that have effective therapies available. This is important because it suggests that some patients with bile duct cancer could benefit from existing treatments that have been successful in other types of cancer. Who this helps: Patients with bile duct cancer who have high levels of CLDN18.

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This study focused on creating standardized guidelines for clinical trials that test new treatments for celiac disease, a condition where eating gluten can harm the intestines. Experts evaluated different trial designs and agreed that patients who have followed a strict gluten-free diet for at least 12 months should be included in these trials. They also concluded that specific ways to measure treatment success should be used, including looking at tissue samples and patient feedback. Who this helps: This helps patients with celiac disease by ensuring that future treatments are tested effectively.

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Researchers studied how US and Korean pathologists diagnose gastrointestinal tumors by evaluating 100 biopsy images and finding out how often they agreed on their diagnoses. They found that both groups generally agreed on their assessments most of the time (74-100%) but had different focuses; for example, Korean pathologists were more concerned with cell structure, while US pathologists looked for signs of cancer invasion. This matters because understanding these differences can help improve communication and diagnostic accuracy between these groups, ultimately leading to better patient care. Who this helps: Patients with gastrointestinal cancers by ensuring more accurate diagnoses and treatment plans.

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This study focused on a treatment called RMC-7977 for pancreatic cancer, which is often driven by specific genetic mutations. The researchers found that RMC-7977 was effective in reducing tumor growth in lab models and extended survival in mice with pancreatic cancer. About 90% of pancreatic cancer cases are linked to these mutations, highlighting the importance of finding effective treatments. Who this helps: This helps patients with pancreatic cancer, particularly those with KRAS mutations.

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This study examined how bile acids in the blood relate to Barrett's esophagus (BE) and its progression to esophageal adenocarcinoma (EAC). Researchers found that specific bile acids, especially cholic acid, were linked to more severe forms of BE and EAC, with a notable finding that high cholic acid levels doubled the risk of high-grade dysplasia or cancer. Understanding these bile acid patterns could help identify patients at higher risk and lead to new ways to prevent or treat advanced stages of esophageal cancer. Who this helps: This helps patients with Barrett's esophagus and doctors treating them.

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This study looked at whether a certain lab finding called erythrophagocytosis, which involves the ingestion of red blood cells by immune cells, could reliably help diagnose hemophagocytic lymphohistiocytosis (HLH) in patients undergoing liver biopsies. The researchers found that twelve liver pathologists were unable to agree on the presence of this finding, showing only 1.4% consistency in their assessments across 141 liver biopsy images. Because of this lack of agreement and the absence of a link to actual HLH cases, erythrophagocytosis is not a reliable indicator for diagnosing this serious condition. Who this helps: This helps doctors and medical professionals by clarifying that they should not rely on this lab finding when diagnosing HLH.

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This study looked at colorectal polyps, growths that can potentially turn into cancer, to understand how often they have concerning features, like being larger than 1 cm or showing signs of precancerous cells. Researchers examined nearly 2,700 polyps from over 1,800 patients and found that 5% had serious features, with rates varying significantly between hospitals—from 1.7% to 9.3%. The size of the polyp was the biggest factor linked to these advanced features, with larger polyps being much more likely to show them. Who this helps: This research benefits doctors and patients by highlighting the importance of polyp size in assessing cancer risk and improving screening evaluations.

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This study looked at how the absence of a specific signaling pathway (IFN-γR/STAT1) in immune cells affects a complication called graft-versus-host disease (GVHD), which can occur after a transplant. Researchers found that mice lacking this signaling had more active donor immune cells, which led to quicker deaths when GVHD developed. Understanding this relationship can help improve treatments for organ transplants and autoimmune diseases by shedding light on how immune responses work. Who this helps: This helps patients receiving organ transplants and their doctors.

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This study looks at the difficulties doctors face when diagnosing intrahepatic cholangiocarcinoma, a rare type of liver cancer. The researchers found that because it is uncommon, many doctors may not have enough experience with it, and it can look similar to other common tumors, leading to mistakes. Understanding these challenges is important because accurate diagnosis is crucial for patients to receive the right treatment. Who this helps: This helps doctors and patients affected by liver cancer.

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Researchers studied a type of cell in the small intestine called Paneth cells and how they respond to infections and inflammation. They found that an infection increases a specific group of Paneth cells, which in turn is linked to the worsening of inflammatory diseases, both in mice and in humans. This is important because it reveals a potential target for treating inflammatory conditions by managing how these cells respond to infections. Who this helps: This helps patients suffering from inflammatory diseases.

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This study looked at two specific proteins, called κB-Ras 1 and κB-Ras 2, which help prevent the growth of tumors. The researchers found that when these proteins are less active or missing in certain cancers, it is linked to a higher chance of poor outcomes for patients. For example, lower levels of κB-Ras 1 were connected to worse prognosis in at least four different types of cancer. Who this helps: This helps patients with cancers lacking specific mutations by highlighting the importance of maintaining healthy levels of tumor-suppressor proteins in treatment considerations.

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This study looked at how accurately eight pathologists can identify whether certain types of left-sided colon polyps are invasive cancers or false alarms where normal tissue appears cancerous. They reviewed 28 colon polyps and found that pathologists mostly agreed on the presence of invasive adenocarcinoma in 86% of cases, but there was less certainty about distinguishing pseudoinvasion from cancer, with only 68% agreement on that. This matters because better agreement among doctors could lead to more accurate diagnoses, ultimately affecting treatment decisions for patients with colon polyps. Who this helps: This helps patients undergoing colon polyp evaluations and their doctors.

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This study focused on a specific type of liver cancer called steatohepatitic hepatocellular carcinoma, which is linked to a liver condition called nonalcoholic steatohepatitis. Researchers found that this cancer has a unique set of gene expressions that makes it different from conventional liver cancers, including notable increases in certain genes like GLI1 and decreases in others like carnitine palmitoyltransferase 2. Understanding these differences is important because it can lead to better-targeted treatments for this specific type of cancer. Who this helps: This helps patients with steatohepatitic hepatocellular carcinoma by potentially leading to more effective therapies.

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This study looked at a rare type of intestinal growth called composite intestinal adenoma-microcarcinoid (CIAM), which contains two different types of tissue. Researchers found that CIAM occurs in about 3.8% of colorectal polyps that are surgically removed, and its tiny carcinoid component typically measures between 3.9 to 5.8 millimeters. Recognizing CIAM is crucial for getting the right diagnosis and treatment, as removing it completely usually leads to a good outcome. Who this helps: This benefits patients undergoing treatment for colorectal polyps and their doctors.

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This study explored the lung tissue of 19 people who died from severe COVID-19 and compared it to seven healthy individuals. Researchers found significant changes in the types of cells in the lungs of those who died, including high levels of inflammation and immune cell activity, but poor responses from T cells, which are crucial for fighting infections. The findings highlight how COVID-19 severely disrupts lung function and may lead to long-term issues for survivors, pointing to potential new treatments. Who this helps: This helps patients recovering from COVID-19 and doctors treating lung-related complications.

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This study looked at a test called albumin in situ hybridisation (ISH) to see if it can help identify certain types of liver cancer in children, specifically hepatoblastoma and fibrolamellar hepatocellular carcinoma. Researchers found that albumin ISH accurately identified all cases of these cancers, achieving 100% sensitivity and specificity for both conditions, while another test called arginase-1 also performed perfectly, but the traditional test, HepPar 1, was less reliable. This matters because accurate diagnosis can lead to better treatment decisions for children with liver cancers. Who this helps: This helps pediatric patients with liver cancer and their doctors.

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This study looked at a protein called SATB2 to see how well it can help tell colorectal cancer apart from cancer in the lung, pancreas, and stomach. Researchers tested 335 cancer samples and found that 87% of colorectal cancers showed SATB2, while only a small percentage of cancers from other sites did—like 3% in lung and 2% in pancreatic cancers. This matters because it helps doctors more accurately diagnose colorectal cancer compared to other types, which can lead to better treatment decisions. Who this helps: This helps doctors and patients by improving cancer diagnosis.

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This study looked at how consistently different expert pathologists diagnosed dysplasia (cell changes that can lead to cancer) in patients with inflammatory bowel disease (IBD). They found that the agreement among pathologists was fair to moderate, with a kappa score of 0.42, meaning that they often disagreed on the severity of dysplasia. Mentorship during training didn't significantly improve the accuracy of these diagnoses, which is important because consistent diagnosis is crucial for effective treatment of patients. Who this helps: This helps doctors and pathologists improve their diagnostic accuracy in IBD patients.

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This study looked at a type of heart disease called wild-type transthyretin cardiac amyloidosis (ATTRwt-CA), which is more common than people thought. Researchers found two patients who had heart issues along with liver problems, but their liver disease was due to a rare condition unrelated to their heart disease. This is important because it shows that doctors should consider different causes for liver problems in patients with this type of heart disease, rather than assuming the liver issues are just a result of heart failure. Who this helps: This primarily benefits doctors and healthcare teams treating patients with ATTRwt-CA.

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This study looked at a specific type of genetic change, called kinase fusions, in advanced breast cancer by analyzing data from 4,854 patients. Researchers found that only 27 patients (about 0.6%) had these fusions, which were mostly seen in patients whose cancer was resistant to hormone treatment and didn’t have certain common mutations. The findings are important because they highlight an alternative genetic pathway that doctors can target for new treatment options, especially for patients not responding to standard therapies. Who this helps: Patients with advanced, hormone-resistant breast cancer.

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This study looked at 23 patients with a rare inflammatory condition called malakoplakia that affects the gastrointestinal tract. It found that most of these patients (91%) were immunocompromised due to factors like cancer or organ transplants, and the condition was most common in the sigmoid colon and rectum. This matters because understanding how malakoplakia presents in these patients can aid in diagnosis and treatment, especially since many are already facing significant health challenges. Who this helps: This helps patients with weakened immune systems and their doctors.

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This study looked at lung samples from 24 patients who died from COVID-19 to understand how the virus affects the lungs. Researchers found that some patients had high levels of the virus while others had low levels, which was linked to how long they were sick and changes in their immune response. The findings reveal that the virus behaves differently within the lungs of different patients, which could impact how we treat COVID-19. Who this helps: This helps doctors and researchers working on COVID-19 treatments.

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This study looked at how different liver pathologists interpret histologic features related to idiopathic non-cirrhotic portal hypertension (INCPH), a liver condition that can look similar to other diseases. The researchers found that agreement among pathologists on what is normal or abnormal in liver samples was low, with scores indicating only slight to fair agreement even when clinical history was provided. This is important because it shows that the features associated with INCPH can occur in patients without the condition, which could lead to misdiagnosis. Who this helps: This helps doctors by highlighting the need for careful interpretation of liver samples to avoid incorrect diagnoses.

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This study examined lung samples from 24 patients who died from COVID-19 to understand how the virus behaves differently in various individuals. Researchers found that patients with high levels of the virus showed strong activation of immune responses, while those with lower levels had more varied responses that seemed tied to individual differences. Understanding these variations is important because it can help inform treatment strategies and improve patient outcomes. Who this helps: This benefits patients and doctors by guiding more effective treatments based on how the virus affects different individuals.

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This study examined the liver damage seen in 40 patients who died from COVID-19. The researchers found that three-quarters of the patients had a condition called macrovesicular steatosis, which means there was significant fat buildup in the liver. Additionally, liver enzymes were elevated, indicating liver injury, with peak levels reaching 68 U/L for one enzyme and 102 U/L for another, both higher than normal. This research is important because it highlights that COVID-19 can severely affect the liver, which is important for understanding the full impact of the virus on health. Who this helps: Patients and doctors working with those who suffer from severe COVID-19 complications.

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This study focuses on a 6-month-old baby who received a liver transplant and was diagnosed with COVID-19 just four days later. After initially recovering well, her liver enzyme levels rose significantly, indicating liver irritation, but her condition improved after treatment with hydroxychloroquine and other medications. This finding highlights the potential complications that COVID-19 can cause in young liver transplant patients and the importance of monitoring and adjusting their treatment. Who this helps: This helps pediatric patients who have undergone liver transplants and their healthcare providers.

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An infant who received a living-donor liver transplant developed COVID-19 hepatitis when the donor later tested positive for the virus. Liver function deteriorated but the patient recovered without losing the graft. This early case documented that COVID-19 can affect transplanted liver allografts and prompted questions about donor screening protocols.

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This study looked at how often pathologists used a specific test (immunohistochemistry or IHC) to diagnose Helicobacter pylori infection, which is a common stomach bacterium. Researchers found that, on average, 12.1% of gastric biopsies showed an H. pylori infection, while IHC was used in 45.2% of cases, yet there was no link between how often IHC was used and how many infections were actually diagnosed. This means that using this test more frequently doesn't necessarily help find more infections. Who this helps: This helps doctors understand that ordering more IHC tests won’t necessarily improve diagnosis rates for H. pylori.

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This study focuses on how pathologists diagnose celiac disease through biopsies of the small intestine. It explains that while certain tissue changes, like villus atrophy (where the tiny finger-like projections in the intestine shrink), are typical in celiac disease, they can also look similar to changes seen in other intestinal disorders. Understanding these similarities is important to ensure accurate diagnoses and treatment for patients, especially since these misdiagnoses can lead to delayed care. Who this helps: This helps patients with celiac disease and doctors making the diagnosis.

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This study focused on a specific type of bacteria found in the mouth and its role in promoting colorectal cancer. Researchers found that this bacteria encourages the growth of colorectal cancer cells by increasing levels of a protein called Annexin A1, which is linked to faster cancer progression; higher levels of Annexin A1 indicate a worse outlook for patients. This research highlights a two-step process in cancer development where genetic mutations are the first step, and the bacteria act as a second, harmful influence. Who this helps: This helps patients at risk for colorectal cancer by offering potential new targets for treatment.

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This research paper looks at different types of liver cancer known as hepatocellular carcinoma (HCC) and how new methods of testing can help doctors classify and treat it better. The study found that using advanced techniques like molecular testing can improve diagnoses and help group patients into categories that can tailor their treatment more effectively. This is important because it can lead to more targeted therapies, which could improve patient outcomes. Who this helps: This helps patients with liver cancer and their doctors by providing better diagnosis and treatment options.

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This research studied patients with celiac disease to understand the role of certain dying cells in the intestines, known as crypt apoptotic bodies (ABC), and their relationship to the disease. Researchers found that the average number of these apoptotic bodies was much higher in untreated celiac disease patients (5.44 per crypt) compared to those on a gluten-free diet (2.60) and to healthy controls (1.79). This indicates that higher levels of these damaged cells contribute to the disease's tissue changes, showing that gluten-free diets can significantly reduce but not completely normalize these levels, which is important for understanding how celiac disease affects the intestine. Who this helps: This helps patients with celiac disease and their healthcare providers by highlighting the impact of dietary changes on their condition.

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This study looked at a rare condition called eosinophilic enteritis in a patient with advanced skin cancer who was being treated with two immune checkpoint inhibitors, ipilimumab and nivolumab. The patient developed high levels of eosinophils, a type of white blood cell, which caused inflammation and digestive problems. Treatment with steroids rapidly improved the patient's symptoms and reduced the high eosinophil levels. Understanding this condition is important because it highlights a potential side effect of these cancer treatments and how it can be managed. Who this helps: This helps patients undergoing treatment for advanced melanoma and their doctors.

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This study looked at specific genetic changes in immune cells from patients with coeliac disease, focusing on those with a severe form called refractory coeliac disease type II (RCDII). The researchers found that 67% of patients with RCDII had these clonal changes, compared to only 6% of patients on a gluten-free diet and 17% of those with a less severe form, RCDI. Understanding these genetic patterns is important because it can help doctors accurately diagnose and classify different types of coeliac disease, particularly when symptoms are complex. Who this helps: This research benefits patients with coeliac disease and their doctors by improving diagnosis and management of the condition.

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This study looked at different tests that help doctors identify high-grade liver tumors when the standard tissue samples are difficult to interpret. Researchers reviewed a variety of tests, including specific stains and RNA tests, that can confirm whether a tumor comes from liver cells, especially in tricky cases like fibrolamellar carcinoma or intrahepatic cholangiocarcinoma. These tests make it easier to diagnose and treat liver tumors accurately, which is crucial for effective patient care. Who this helps: This helps doctors and patients facing liver tumor diagnoses.

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This study looked at how HER2, a protein linked to cancer growth, is expressed in biopsies (small tissue samples) compared to larger tissue samples (resections) in patients with advanced gastroesophageal cancers. Out of 100 patients tested, 60% had biopsies that were initially negative or uncertain for HER2 but showed signs of HER2 overexpression when larger samples were examined, potentially impacting treatment eligibility. This is important because accurately assessing HER2 can help doctors determine who may benefit from targeted treatments that improve survival outcomes. Who this helps: This helps patients with advanced gastroesophageal cancers by ensuring they receive the best possible treatment based on accurate HER2 testing.

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This paper examined the difficulties pathologists face in identifying medication resins, such as Kayexalate and sevelamer, in gastrointestinal specimens. It found that pathologists correctly recognize these resins only 75% of the time, and their appearance can change, making diagnosis less straightforward. This is important because accurate identification can lead to better understanding and treatment of conditions related to these medications. Who this helps: This benefits patients on these medications, as well as doctors diagnosing their conditions.

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This study looked at a 3-month-old boy who developed severe liver failure due to a condition called mitochondrial DNA depletion, which affects energy production in cells. Researchers discovered that he had a specific genetic change (a missense variant) in a gene called POLG2, which is essential for copying mitochondrial DNA. This is significant because it is the first identified case of a homozygous mutation in POLG2 linked to such serious liver problems, highlighting the importance of genetic testing in understanding and diagnosing similar cases. Who this helps: This research helps doctors and families dealing with rare genetic conditions in infants.