{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T07:35:15Z","timestamp":1786865715485,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T00:00:00Z","timestamp":1527638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Gastric heterotopia (<jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>) has been described throughout the gastrointestinal tract. However, the colorectal region is an extremely rare location for it. We describe the clinicopathological features of <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> of the colon, rectum and anus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We identified 33 cases in 20 males and 13 females (median age\u00a0=\u00a054\u00a0years; range\u00a0=\u00a04\u00a0months\u201373\u00a0years). Sites included the rectum (<jats:italic>n<\/jats:italic>\u00a0=\u00a026), anus (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), ileocaecal junction (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), ascending colon (<jats:italic>n<\/jats:italic>\u00a0=\u00a01) and descending colon (<jats:italic>n<\/jats:italic>\u00a0=\u00a01). Presenting symptoms (<jats:italic>n<\/jats:italic>\u00a0=\u00a027) included haematochezia (41%) and altered bowel habits (4%); 15 patients (55%) were asymptomatic. On colonoscopy (<jats:italic>n<\/jats:italic>\u00a0=\u00a031), all appeared as solitary lesions (median size\u00a0=\u00a06.5\u00a0mm, range\u00a0=\u00a02\u201355\u00a0mm), either as polyps (61%), raised erythematous patches (23%), an ulcer (10%), within a rectal diverticulum (3%) or a haemorrhoid (3%). Patients were managed by polypectomy. One with an associated carcinoma in the area of <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> underwent resection. No morbidity related to <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> itself was reported following excision. Histologically, heterotopic gastric mucosa was oxyntic (85%), mixed oxyntic and non\u2010oxyntic (12%) and not specified (3%) types. In five patients a pyloric gland adenoma (<jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content>) arose from heterotopic gastric mucosa, two of which contained a focus of invasive adenocarcinoma. One case had associated surface foveolar\u2010type low\u2010grade dysplasia. Another had associated adenocarcinoma arising from the heterotopic mucosa. One example harboured <jats:italic>Helicobacter pylori<\/jats:italic> organisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We highlight the features of <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> in the distal <jats:styled-content style=\"fixed-case\">GIT<\/jats:styled-content> \u2013 the \u2018outlet patch\u2019. Association with <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content>, surface dysplasia and adenocarcinoma suggests that\u00a0lower tract <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> can undergo neoplastic transformation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13632","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T12:07:41Z","timestamp":1524053261000},"page":"220-229","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The outlet patch: gastric heterotopia of the colorectum and anus"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0369-5744","authenticated-orcid":false,"given":"Abul A S R","family":"Mannan","sequence":"first","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Vieth","sequence":"additional","affiliation":[{"name":"Institute of Pathology Klinikum Bayreuth Bayreuth Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7928-2511","authenticated-orcid":false,"given":"Armen","family":"Khararjian","sequence":"additional","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binny","family":"Khandakar","sequence":"additional","affiliation":[{"name":"Mount Sinai Beth Israel Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Lam\u2010Himlin","sequence":"additional","affiliation":[{"name":"Mayo Clinic Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Heydt","sequence":"additional","affiliation":[{"name":"Capital Digestive Care Rockville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feriyl","family":"Bhaijee","sequence":"additional","affiliation":[{"name":"AmeriPath Indiana Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry J","family":"Venbrux","sequence":"additional","affiliation":[{"name":"Jackson Siegelbaum Gastroenterology and PAGI Camp Hill PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Byrnes","sequence":"additional","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lysandra","family":"Voltaggio","sequence":"additional","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Barker","sequence":"additional","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songyang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Mount Sinai Beth Israel Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.3.5613.267"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/gow006"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-009-4269-1"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-012-0221-x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181888feb"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2013.860558"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000177"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i46.17588"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i3.331"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2010.12.004"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-005-1242-2"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.4132\/KoreanJPathol.2013.47.3.289"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.4103\/0377-4929.41668"},{"key":"e_1_2_5_15_1","first-page":"641","article-title":"Aberrant gastric mucosa in the rectum with ulceration and hemorrhage","volume":"38","author":"Ewell GH","year":"1939","journal-title":"Wis. 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