Evidence map›Paper›PMID 30020094›Full record

ArticleThe American journal of surgical pathology2018

Epithelial Inclusions in Gallbladder Specimens Mimic Parasite Infection: Histologic and Molecular Examination of Reported Cystoisospora belli Infection in Gallbladders of Immunocompetent Patients.

Eric A Swanson, Jordon K March, Frederic Clayton, Marc R Couturier, Ramir Arcega, Richard Smith, Kimberley J Evason

Open access · greenAbstract read
In one paragraph

Article in The American journal of surgical pathology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.3field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Eric A SwansonDepartment of Pathology.
Jordon K MarchDepartment of Pathology.
Frederic ClaytonDepartment of Pathology.
Marc R CouturierDepartment of Pathology.
Ramir ArcegaDepartment of Pathology, Cedar-Sinai Medical Center, Los Angeles, CA.
Richard SmithDepartment of Pathology.
Kimberley J EvasonDepartment of Pathology.
Cedars-Sinai Medical Center · USHuntsman Cancer Institute · US

Funding

UTAH REGIONAL CANCER CENTERP30CA042014 · NCI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI KATHARINE S ULLMAN · 1986 to 2026
$72.6M
Serotonergic antidepressants as liver tumor preventivesR01CA222570 · NCI · UNIVERSITY OF UTAH · PI EVASON, KIMBERLEY JANE · 2018 to 2022
$1.8M
Mechanisms and modifiers of beta-catenin-induced hepatic tumorigenesisK08CA172288 · NCI · UNIVERSITY OF UTAH · PI EVASON, KIMBERLEY JANE · 2013 to 2017
$754k
NCI NIH HHS K08 CA172288NCI NIH HHS P30 CA042014NCI NIH HHS R01 CA222570
6 · The paper itself

Abstract

Recent publications have described epithelial cytoplasmic vacuoles and inclusions incidentally noted within gallbladder epithelium and concluded that they represent coccidian parasite infection, in particular, Cystoisospora belli. We identified 8 gallbladder specimens from our institution in the past 3 years in which this diagnosis was suggested or in which similar epithelial alterations were prominent. Molecular analysis was performed on the 8 gallbladder specimens and on 3 positive control specimens: small bowel biopsies from acquired immunodeficiency syndrome patients with diarrhea. Polymerase chain reaction using primers designed to amplify an internal transcribed spacer (ITS2) in the C. belli ribosomal gene cluster was performed on the DNA samples. All 8 gallbladder specimens were negative for amplification, while a product consistent with C. belli was amplified from all 3 positive controls. Histologically, the gallbladder cytoplasmic inclusions stained diffusely positive for Grocott-Gomori's methenamine silver and Periodic acid-Schiff with diastase. In contrast, sections from a positive control small bowel biopsy demonstrated organisms that were negative for Grocott-Gomori's methenamine silver and showed a distinct capsular and punctate internal staining on Periodic acid-Schiff with diastase in various parasite forms. Together, the lack of molecular evidence of C. belli and the distinct morphologic and special staining patterns in these gallbladders compared with positive control small bowel suggest that these epithelial changes do not represent true C. belli infection. Our results suggest that gallbladders of immunocompetent patients may occasionally show epithelial changes that can morphologically mimic C. belli infection. Pathologists should be aware of this histologic variant to minimize unnecessary treatment, testing, and patient anxiety.

Indexed as

ImmunocompetenceAdultAgedDatabases, FactualDiagnosis, DifferentialDNA, ProtozoanEpithelial CellsFemaleGallbladderGallbladder DiseasesHost-Pathogen InteractionsHumansInclusion BodiesIsosporaIsosporiasisMaleDNA, Protozoan

Identifiers

PMID30020094
PMCPMC6133732
OpenAlexW2883686327

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.