Difference between revisions of "Traditional serrated adenoma"
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| Width = Traditional serrated adenoma. [[H&E stain]]. | | Width = Traditional serrated adenoma. [[H&E stain]]. | ||
| Caption = | | Caption = | ||
| Micro = serrated, eosinophilic cytoplasm, villous-like architecture | | Micro = ectopic crypt foci (ECF), serrated, eosinophilic cytoplasm, villous-like architecture, "pine cone, fernlike, stellate pit pattern" | ||
| Subtypes = | | Subtypes = With and without high grade dysplasia, mixed with other types of polyps | ||
| LMDDx = [[villous adenoma]] | | LMDDx = [[villous adenoma]], [[hyperplasic polyp]], [[sessiles serrated adenoma]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = CK20 in the eosinophilic cells, absent in ECF; Ki67 (MIB1) stains ECF and absent in eosinophilic cells, MUC2+, MUC5CA+, MUC6-; In areas of dysplasia TP53+, nuclear B-catenin+; p16+ in late dysplasia | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = [[BRAF]] & [[KRAS]] | ||
| IF = | | IF = | ||
| Gross = | | Gross = | ||
| Line 23: | Line 23: | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = q3year surveillance colonoscopy | ||
| Prognosis = benign (pre-malignant) | | Prognosis = benign (pre-malignant) | ||
| Other = | | Other = | ||
Revision as of 01:31, 20 May 2015
| Traditional serrated adenoma | |
|---|---|
| Diagnosis in short | |
 | |
|
| |
| LM | ectopic crypt foci (ECF), serrated, eosinophilic cytoplasm, villous-like architecture, "pine cone, fernlike, stellate pit pattern" |
| Subtypes | With and without high grade dysplasia, mixed with other types of polyps |
| LM DDx | villous adenoma, hyperplasic polyp, sessiles serrated adenoma |
| IHC | CK20 in the eosinophilic cells, absent in ECF; Ki67 (MIB1) stains ECF and absent in eosinophilic cells, MUC2+, MUC5CA+, MUC6-; In areas of dysplasia TP53+, nuclear B-catenin+; p16+ in late dysplasia |
| Molecular | BRAF & KRAS |
| Site | colon - usu. left side / gastrointestinal polyps |
|
| |
| Prevalence | very rare |
| Endoscopy | q3year surveillance colonoscopy |
| Prognosis | benign (pre-malignant) |
| Clin. DDx | other GI polyps |
| Treatment | polypectomy |
Traditional serrated adenoma, abbreviated TSA, are a rare type of gastrointestinal polyp.
Before the sessile serrated adenomas were recognized, these lesions were known as serrated adenomas.[1]
General
- Very rare.
- Pre-malignant.[2]
Gross
- Polypoid mass.
- Usually in the left colon.
Microscopic
Features:[3]
- Serrated - essential.
- Eosinophilic cytoplasm - key feature.
- Nuclear atypia as in tubular adenoma.
- Nuclear hyperchromasia, enlargement and pseudostratification.
- Villous-like architecture.
DDx:
Images
TSA - low mag. (WC/Nephron)
TSA - intermed. mag. (WC/Nephron)
TSA - very high mag. (WC/Nephron)
TSA - low mag. (WC/Nephron)
TSA - intermed. mag. (WC/Nephron)
TSA - high mag. (WC/Nephron)
TSA - very high mag. (WC/Nephron)
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POLYP, SIGMOID COLON, POLYPECTOMY: - TRADITIONAL SERRATED ADENOMA. -- NEGATIVE FOR HIGH-GRADE DYSPLASIA.
See also
References
- ↑ Noffsinger, AE.; Hart, J. (Jul 2010). "Serrated adenoma: a distinct form of non-polypoid colorectal neoplasia?". Gastrointest Endosc Clin N Am 20 (3): 543-63. doi:10.1016/j.giec.2010.03.012. PMID 20656251.
- ↑ Rosty, C.; Hewett, DG.; Brown, IS.; Leggett, BA.; Whitehall, VL. (Mar 2013). "Serrated polyps of the large intestine: current understanding of diagnosis, pathogenesis, and clinical management.". J Gastroenterol 48 (3): 287-302. doi:10.1007/s00535-012-0720-y. PMID 23208018.
- ↑ Li SC, Burgart L (March 2007). "Histopathology of serrated adenoma, its variants, and differentiation from conventional adenomatous and hyperplastic polyps". Arch. Pathol. Lab. Med. 131 (3): 440-5. PMID 17516746. http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=0003-9985&volume=131&page=440.