Foveolar type dysplasia

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Foveolar type dysplasia
Diagnosis in short

Foveolar dysplasia of the duodenum. H&E stain.

Synonyms type 2 dysplasia, foveolar dysplasia, foveolar/hyperplastic dysplasia
LM DDx benign foveolar epithelium, gastric heterotopia (if not stomach), benign ampullary epithelium, hyperplastic polyp
Site stomach, duodenum (esp. ampulla of Vater), esophagus

Syndromes familial adenomatous polyposis

Prevalence not common
Other may be subtle

Foveolar type dysplasia, also foveolar dysplasia, is a form of dysplasia that arises from the foveolar cells, typically seen in the stomach. It may be subtle to unaccustomed eyes.

It is also described as non-adenomatous dysplasia, type 2 dysplasia and foveolar/hyperplastic type dysplasia.[1]

General

Microscopic

Features:

  • Tall columnar cells with basal nuclei in a villiform architecture.[1]
  • +/-Proliferative activity - mitotic figures.

DDx:

Images

www:

IHC

Features:[2]

  • p53 +ve.
  • Ki-67 increased staining in ~100% of cases.

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A. Polyp, Stomach, Biopsy or Polypectomy:
	- Polypoid fragment of gastric body type mucosa with low-grade DYSPLASIA, foveolar type, see comment. 
	- NEGATIVE for Helicobacter-like organisms.
	- NEGATIVE for intestinal metaplasia.
	- NEGATIVE for evidence of malignancy.
 
Comment:
The sections show foveolar type epithelium with proliferation and hyperchromasia extending to the surface. A p53 and Ki-67 show diffuse staining in the abnormal epithelium.  The architectural complexity is mild in the abnormal epithelium. Deepers were cut (x3); these are non-contributory.  

See also

References

  1. 1.0 1.1 1.2 Brown, IS.; Whiteman, DC.; Lauwers, GY. (Jun 2010). "Foveolar type dysplasia in Barrett esophagus.". Mod Pathol 23 (6): 834-43. doi:10.1038/modpathol.2010.59. PMID 20228780.
  2. Testino G, Cornaggia M, Ferrando V (2007). "Low- and high-grade non-invasive gastric neoplasia (formerly dysplasia): cytological differentiation (gastro-entero-pancreatic antigens) in association with p53 pattern expression". Hepatogastroenterology 54 (73): 1–3. PMID 17419219.