Report on the 6th H-ECCO IBD Masterclass at ECCO’21
Gert De Hertogh, H-ECCO Chair
|Gert De Hertogh
The past 2 years, 2020 and 2021, have been challenging for everybody, but with the help of the ever-enthusiastic ECCO Organisation and their co-workers, the H-ECCO Committee was able to organise a well-attended masterclass at the recent virtual congress in July.
We divided the masterclass into four sessions: Basics of IBD, Scoring Schemes and Standards, Neoplasia and New Concepts in IBD.
The session on Basics of IBD was chaired by Peter Bossuyt, a gastroenterologist (Belgium), and by Ann Driessen, a pathologist in Antwerp (Belgium) and an H-ECCO Committee Member. Perhaps for the first time in our masterclass, we also had a presentation on the patients’ viewpoint: What are the patient’s priorities? This was aptly given by Petra Hartmann, Chair of the German IBD Nurse Association. Michel Adamina (Switzerland) and Peter Irving (United Kingdom) discussed the surgical and gastroenterological features of IBD, and emphasised once more which pathology information they would like to obtain from us. The pathologist’s views on diagnosis, differential diagnosis and pitfalls in surgical specimens and endoscopic biopsies were then presented by Monika Tripathi (United Kingdom) and Pamela Baldin (Belgium), and also nicely illustrated by Francesca Rosini (Italy), all three of whom are H-ECCO Committee Members.
The session on Scoring Schemes and (reporting) Standards was introduced into the course because we all feel that disease activity scoring (endoscopically and on biopsies) is becoming more and more important for the daily clinical treatment of our patients. Likewise, there is a strong trend towards standardised reporting of IBD specimens, which is endorsed by the professional pathologists’ organisations. This session was presided over by Francesca Rosini and Roger Feakins (United Kingdom), past H-ECCO Chair. Ann Driessen and myself had the honour of discussing IBD biopsy scoring together with Fernando Magro, a gastroenterologist (Portugal). Both clinical and endoscopic scoring systems, biopsy requirements, histological scoring and reproducibility were touched upon and further discussed by the speakers. Next, Monika Tripathi beautifully illustrated how IBD histology may be modified by medical and surgical therapy. Roger Feakins then presented proposals for datasets and standards for IBD pathology reporting, which will probably soon find their way into clinical practice. Pamela Baldin closed the session with another slide seminar on one of those difficult and potentially baffling cases that we occasionally encounter.
The first afternoon session on IBD neoplasia – a classic – was chaired by James Lindsay (United Kingdom) and Magali Svrcek (France). This part of the masterclass, introduced by James Lindsay from the clinical point of view and illustrated in a slide seminar by Ann Driessen, covered many types of malignancy which may arise in the context of IBD. I wish to thank especially Shaun Walsh (United Kingdom) and Magali Svrcek for their very informative talks on neuroendocrine neoplasms and intestinal adenocarcinoma, respectively. Other topics were cholangiocarcinoma (Francesca Rosini) and non-epithelial neoplasia (Pamela Baldin).
The final session, on New Concepts in IBD, was chaired by Pamela Baldin and myself. Traditionally, this session has included an overview of “Hot Topics in IBD”, delivered by Magali Svrcek. This was the first year that I took over from her, and I discovered that even in such an eventful year as this, a lot of varied IBD research has still been going on. Roger Feakins next gave a very clear and complete overview of the problem of fibrosis in IBD, covering its origin and development, its assessment, and whether we may one day be able to treat it at an early stage. Another first was the presentation by Francesca Rosini on digital pathology and artificial intelligence in IBD. Both applications have already entered the field and I am sure that we will hear more about them in the coming years. Artificial intelligence especially has the potential to alter both clinical and pathology practice. Ann Driessen followed up on this with an extensive and well-illustrated lecture on the many newer and rarer mimics of IBD pathology that we may occasionally encounter in our practice. Lastly, we had the honour of welcoming Irene Esposito (Germany), who gave a talk on the many ways in which IBD may influence and interact with the pancreas.
As H-ECCO Chair, I wish expressly to thank all our non-pathologist and pathologist colleagues who contributed to our masterclass as speakers or session chairs. Next, I want to thank and congratulate all the current H-ECCO Committee Members, who worked hard to put together an interesting programme, to suggest and contact speakers and, of course, to chair sessions and prepare and give lectures themselves. Throughout these efforts, we were supported by the ECCO Organisation, who masterfully kept everybody and everything on track and running smoothly.
Lastly, I thank you, our public, for being there and supporting us, and for asking questions which forced us to think and perhaps re-think our IBD concepts. I hope you enjoyed it all and I dearly wish to see you back “in flesh and blood” on the occasion of the ECCO'22 Vienna Congress.
It was a pleasure working with you all,
Gert De Hertogh
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