Report on the 5th H-ECCO IBD Masterclass at ECCO'20

This year, the 5^th H-ECCO IBD Masterclass took place at the ECCO Congress in Vienna. As usual, it consisted of four sessions with different emphases: Diagnosis; Challenges; Mimics and Associations; and Evolving Concepts. Speakers were from the United Kingdom, Belgium, France, Portugal and Canada. We also had the privilege of welcoming for the first time a North American-based speaker, Bob Riddell, who is one of the top gastrointestinal pathologists in the world. He delivered a comprehensive and appealing talk on the involvement of the appendix by IBD. In addition, it is appropriate to make special mention of Magali Svrcek, who delivered her fifth talk on Hot Topics in IBD pathology. She always manages to produce some new and intriguing information but sadly decided that this would be her last Hot Topics session. Magali also spoke with the ECCO President, Laurent Peyrin-Biroulet, in an entertaining joint clinical and pathological session on serrated lesions.

Earlier talks included “Do I really need a histopathologist” by James Lindsay, which was reassuring for the pathologists in the room (as James was 100% positive about pathology). This was followed by a talk on the basics of IBD pathology diagnosis, by Roger Feakins. The newer members of the Histology Committee also delivered excellent talks. Francesca Rosini discussed multiple possible pathological prognostic factors in IBD, following a comprehensive talk by past ECCO President Séverine Vermeire on the clinical prognostic features. Francesca also delivered a thorough lecture on associations between liver disease and IBD, leaving no stone unturned. Monika Tripathi reviewed macroscopic features of Ulcerative Colitis and Crohn’s Disease expertly, and brought one of her clinical colleagues, Lisa Sharkey, from Cambridge to outline the features of bowel transplantation – from which I am sure everyone in the room learned something new.

A series of discussions and slide seminars on dysplasia was given by Francesca Rosini and Gert de Hertogh, who had carefully selected many illustrative cases. The discussion illustrated differences between pathologists’ approaches to diagnosis and grading of dysplasia but also yielded a reassuring level of agreement that there is no “right answer” and that lack of consistency between pathologists still requires a better solution.

The Mimics session included a talk on clinical mimics by the consistently clear-speaking Peter Irving; I did not realise there were so many! Then there was a summary of unusual patterns of IBD by Roger Feakins, an overview of diverticular colitis and IBD by Shaun Walsh – another clear and professional speaker – and a thoughtful talk on upper GI IBD pathology by Monika. A second invited non-H-ECCO pathologist was Yoh Zen, talking about IgG4 in IBD and other settings. Yoh Zen is a recognised world expert on IgG4, and there is no doubt that this label is fully justified. Other talks were on drugs in IBD, from a knowledgeable Belgian duo, i.e. Gert de Hertogh and Marc Ferrante, and on early-onset IBD from Paula Borralho Nunes, who always seems to be perfectly in tune with the topic about which she talks.

Ending on a personal note, I have greatly enjoyed my time as H-ECCO Chair and particularly enjoyed planning and delivering the Masterclass with enthusiastic colleagues. Please consider attending it if you have not done so already, and returning to it if you have. All feedback is, of course, very welcome.

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