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Difference between revisions of "Traditional serrated adenoma"
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| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = benign (pre-malignant) | | Prognosis = benign (pre-malignant) | ||
| Other = | | Other = | ||
| ClinDDx = other [[GI polyps]] | | ClinDDx = other [[GI polyps]] | ||
| Tx = polypectomy | | Tx = [[polypectomy]], q3years surveillance colonoscopy | ||
}} | }} | ||
'''Traditional serrated adenoma''', abbreviated '''TSA''', are a rare type of [[gastrointestinal polyp]]. | '''Traditional serrated adenoma''', abbreviated '''TSA''', are a rare type of [[gastrointestinal polyp]]. | ||
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==Gross== | ==Gross== | ||
*Polypoid mass. | *Polypoid mass. | ||
*Usually in the left colon. | *Usually in the [[left colon]]. | ||
==Microscopic== | ==Microscopic== | ||
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**Nuclear hyperchromasia, enlargement and pseudostratification. | **Nuclear hyperchromasia, enlargement and pseudostratification. | ||
*Villous-like architecture. | *Villous-like architecture. | ||
*Ectopic crypt foci (ECF) - short crypts oriented perpendicular to the main crypt, do not reach muscularis mucosae.<ref>URL: [http://surgpathcriteria.stanford.edu/gitumors/traditional-serrated-adenoma/printable.html http://surgpathcriteria.stanford.edu/gitumors/traditional-serrated-adenoma/printable.html]. Accessed on: 5 June 2017.</ref>‡ | |||
Note: | |||
*‡ECF considered pathognomonic for TSA - but seen in other entities.<ref name=pmid27281826>{{Cite journal | last1 = Väyrynen | first1 = SA. | last2 = Väyrynen | first2 = JP. | last3 = Klintrup | first3 = K. | last4 = Mäkelä | first4 = J. | last5 = Tuomisto | first5 = A. | last6 = Mäkinen | first6 = MJ. | title = Ectopic crypt foci in conventional and serrated colorectal polyps. | journal = J Clin Pathol | volume = 69 | issue = 12 | pages = 1063-1069 | month = Dec | year = 2016 | doi = 10.1136/jclinpath-2015-203593 | PMID = 27281826 }}</ref> | |||
DDx:<ref>URL: [http://surgpathcriteria.stanford.edu/gitumors/traditional-serrated-adenoma/differential-diagnosis.html http://surgpathcriteria.stanford.edu/gitumors/traditional-serrated-adenoma/differential-diagnosis.html]. Accessed on: 28 May 2015.</ref> | DDx:<ref>URL: [http://surgpathcriteria.stanford.edu/gitumors/traditional-serrated-adenoma/differential-diagnosis.html http://surgpathcriteria.stanford.edu/gitumors/traditional-serrated-adenoma/differential-diagnosis.html]. Accessed on: 28 May 2015.</ref> | ||
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==Sign out== | ==Sign out== | ||
<pre> | |||
Polyp, Sigmoid Colon, Polypectomy: | |||
- Traditional serrated adenoma. | |||
-- NEGATIVE for high-grade dysplasia. | |||
</pre> | |||
===Block letters=== | |||
<pre> | <pre> | ||
POLYP, SIGMOID COLON, POLYPECTOMY: | POLYP, SIGMOID COLON, POLYPECTOMY: | ||
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-- NEGATIVE FOR HIGH-GRADE DYSPLASIA. | -- NEGATIVE FOR HIGH-GRADE DYSPLASIA. | ||
</pre> | </pre> | ||
===Micro=== | |||
====Nonvilliform TSA==== | |||
This polyp has cytologic dysplasia and serrations at the surface; however, it does not have a villiform architecture. The surface epithelium has eosinophilic cytoplasm. Overall, the morphology is most in keeping with a traditional serrated adenoma. | |||
==See also== | ==See also== | ||