New kids on the block: A review of the latest iatrogenic foreign materials seen in gastrointestinal specimens

Dipti M. Karamchandani, Hazed Hammad, Runjan Chetty, Christina A. Arnold

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Context.-With the increasing development and use of iatrogenic agents, pathologists are encountering more novel foreign materials in retrieved gastrointestinal specimens. These colorful and unusual-appearing foreign materials can pose a diagnostic dilemma to those unaware of their morphology, especially if the relevant clinical history is lacking. Objective.-To discuss the histopathologic features, clinical scenarios and significance, and differential diagnosis of relatively recently described, yet quickly expanding, family of iatrogenic agents that can present as foreign materials in gastrointestinal specimens-pharmaceutical fillers (crospovidone and microcrystalline cellulose), submucosal lifting agents (Eleview and ORISE), lanthanum carbonate, hydrophilic polymers, OsmoPrep, yttrium 90 microspheres (SIR-Sphere and TheraSphere), and resins (sodium polystyrene sulfonate, sevelamer, and bile acid sequestrants). Data Sources.-We collate the findings of published literature, including recently published research papers, and authors' personal experiences from clinical sign-out and consult cases. Conclusions.-Correct identification of these iatrogenic agents is important because the presence of some novel agents can explain the histopathologic findings seen in the background specimen, and specific novel agents can serve as diagnostic clues to prompt the pathologist to consider other important and related diagnoses. Awareness of even biologically inert agents is important for accurate diagnosis and to avoid unnecessary and expensive diagnostic studies.

Original languageEnglish (US)
Pages (from-to)1569-1584
Number of pages16
JournalArchives of Pathology and Laboratory Medicine
Issue number12
StatePublished - Dec 2021
Externally publishedYes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology


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