Should we be concerned about histologic changes caused by novel submucosal injection agents used for EMR and ESD

Normal saline mixed with dyes is a widely used submucosal lifting agent for endoscopic resection of small gastrointestinal (GI) lesions. For larger GI lesions, novel agents are used to achieve optimal results. ORISE gel is a novel, premixed submucosal lifting solution for endoscopic resection procedures. The initial histologic appearance of endoscopic specimens with injection of ORISE gel is characterized by a pale, basophilic amorphous appearance which has the potential to be misinterpreted as a pathologic finding. The histologic appearance changes overtime to an eosinophilic appearance that is reflected by an inflammatory, foreign body reaction. We summarize the @GIJournal discussion held on May 12, 2021, about the article by  Olivas et al “Histologic changes caused injection of a novel submucosal lifting agent for endoscopic resection in GI lesions”  1. The guest experts to discuss pathology included Drs. Emma Furth (EF), and Pallavi Patil (PP), the discussion was moderated by Dr. Dmitriy Kedrin (DK).