Original ArticlesSarcina Organisms in the Gastrointestinal Tract A Clinicopathologic and Molecular StudyLam-Himlin, Dora MD*,†; Tsiatis, Athanasios C. MD*,‡; Montgomery, Elizabeth MD*; Pai, Rish K. MD, PhD§; Brown, J. Ahmad MD∥; Razavi, Mohammad MD¶; Lamps, Laura MD∥; Eshleman, James R. MD, PhD*; Bhagavan, Belur MD*; Anders, Robert A. MD, PhD*Author Information *Department of Pathology, Johns Hopkins School of Medicine, Baltimore MD †Department of Pathology Scottsdale, Mayo Clinic, AZ ‡Department of Pathology Philadelphia, University of Pennsylvania, PA §Department of Anatomic Pathology Cleveland, Cleveland Clinic, OH ∥Department of Pathology Little Rock, University of Arkansas for Medical Sciences, AR ¶Department of Internal Medicine and Gastroenterology, Sentara Potomac Hospital, Woodbridge, VA Dora Lam-Himlin and Athanasios C. Tsiatis contributed equally to this study. Conflicts of Interest and Source of Funding: Grant support: National Institute of Health R01DK080736 (R.A.A.); R01DK081417 (R.A.A.); Michael Rolfe Foundation for Pancreatic Cancer Research (R.A.A.). The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Robert A. Anders, MD, PhD, Department of Pathology, Division of Gastrointestinal and Liver Pathology, Room 346, CRB-II, Johns Hopkins University School of Medicine, 1550 Orleans St, Baltimore, MD, 21231 (e-mail: [email protected]). The American Journal of Surgical Pathology: November 2011 - Volume 35 - Issue 11 - p 1700-1705 doi: 10.1097/PAS.0b013e31822911e6 Buy Metrics Abstract Sarcina organisms were first observed in and recorded from the stomach contents of a patient suffering from vomiting by John Goodsir in 1842. Since that time, their fine structure, phylogenetic classification, and biochemical characteristics have been described. Although numerous cases of fatal disease have been attributed to this organism in the veterinary literature, only a few human cases have been documented. As a result, whether this organism causes disease in humans has not been definitively established. We report the clinicopathologic findings in a series of 5 patients with Sarcina-like organisms identified in upper gastrointestinal endoscopic biopsies with molecular confirmation. Our findings have shown that the organism is most commonly found in patients with a history of gastric outlet obstruction or delayed gastric emptying. Although many of the patients do not demonstrate direct mucosal injury from the organism, the presence of a concurrent gastric ulcer puts the patient at increased risk for complications such as emphysematous gastritis or perforation. The finding of Sarcina organisms should prompt further investigation for functional causes of gastric outlet obstruction and delayed gastric emptying, such as occult malignancy. © 2011 Lippincott Williams & Wilkins, Inc.