Traditional serrated adenoma
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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
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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.