Difference between revisions of "Gastrointestinal tract polyps"

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===Microscopic===
===Microscopic===
Features:
Features:
*Serrated.
*Serrated epithelium.
*Crypt dilation at base - a '''key feature''' - very common.  
**Saw-tooth appearance, epithelium has jagged edge.  
**"Boot"-shape or "L"-shaped glands.
*Crypt dilation at base with serrations - '''key feature'''.
**Very common -- anecdotally the most sensitive feature.  
*"Boot"-shape or "L"-shaped glands.
**Shape may be similar to a hockey stick.
*Horizontal crypts (crypts that run along the muscular mucosae).
*Crypt branching.
*Crypt branching.
*Horizontal crypts (crypts that run along the muscular mucosae).


Minimal extent:
Minimal extent criteria:
*[[Onlinepathology]] likes the ''German Society of Pathology'' proposal: at least two different crypts -- crypts do not have to be adjacent.<ref name=pmid23052370>{{Cite journal  | last1 = Ensari | first1 = A. | last2 = Bilezikçi | first2 = B. | last3 = Carneiro | first3 = F. | last4 = Doğusoy | first4 = GB. | last5 = Driessen | first5 = A. | last6 = Dursun | first6 = A. | last7 = Flejou | first7 = JF. | last8 = Geboes | first8 = K. | last9 = de Hertogh | first9 = G. | title = Serrated polyps of the colon: how reproducible is their classification? | journal = Virchows Arch | volume = 461 | issue = 5 | pages = 495-504 | month = Nov | year = 2012 | doi = 10.1007/s00428-012-1319-7 | PMID = 23052370 }}</ref><ref name=pmid20617338>{{Cite journal  | last1 = Aust | first1 = DE. | last2 = Baretton | first2 = GB. | title = Serrated polyps of the colon and rectum (hyperplastic polyps, sessile serrated adenomas, traditional serrated adenomas, and mixed polyps)-proposal for diagnostic criteria. | journal = Virchows Arch | volume = 457 | issue = 3 | pages = 291-7 | month = Sep | year = 2010 | doi = 10.1007/s00428-010-0945-1 | PMID = 20617338 }}</ref>
*''German Society of Pathology'' proposal: at least two different crypts -- crypts do not have to be adjacent.<ref name=pmid23052370>{{Cite journal  | last1 = Ensari | first1 = A. | last2 = Bilezikçi | first2 = B. | last3 = Carneiro | first3 = F. | last4 = Doğusoy | first4 = GB. | last5 = Driessen | first5 = A. | last6 = Dursun | first6 = A. | last7 = Flejou | first7 = JF. | last8 = Geboes | first8 = K. | last9 = de Hertogh | first9 = G. | title = Serrated polyps of the colon: how reproducible is their classification? | journal = Virchows Arch | volume = 461 | issue = 5 | pages = 495-504 | month = Nov | year = 2012 | doi = 10.1007/s00428-012-1319-7 | PMID = 23052370 }}</ref><ref name=pmid20617338>{{Cite journal  | last1 = Aust | first1 = DE. | last2 = Baretton | first2 = GB. | title = Serrated polyps of the colon and rectum (hyperplastic polyps, sessile serrated adenomas, traditional serrated adenomas, and mixed polyps)-proposal for diagnostic criteria. | journal = Virchows Arch | volume = 457 | issue = 3 | pages = 291-7 | month = Sep | year = 2010 | doi = 10.1007/s00428-010-0945-1 | PMID = 20617338 }}</ref>
**[[Onlinepathology]] prefers this definition.
*An expert panel lead by ''Rex'' states that one unequivocally altered crypt should prompt calling SSA.<ref name=pmid22710576>{{Cite journal  | last1 = Rex | first1 = DK. | last2 = Ahnen | first2 = DJ. | last3 = Baron | first3 = JA. | last4 = Batts | first4 = KP. | last5 = Burke | first5 = CA. | last6 = Burt | first6 = RW. | last7 = Goldblum | first7 = JR. | last8 = Guillem | first8 = JG. | last9 = Kahi | first9 = CJ. | title = Serrated lesions of the colorectum: review and recommendations from an expert panel. | journal = Am J Gastroenterol | volume = 107 | issue = 9 | pages = 1315-29; quiz 1314, 1330 | month = Sep | year = 2012 | doi = 10.1038/ajg.2012.161 | PMID = 22710576 }}</ref>
*An expert panel lead by ''Rex'' states that one unequivocally altered crypt should prompt calling SSA.<ref name=pmid22710576>{{Cite journal  | last1 = Rex | first1 = DK. | last2 = Ahnen | first2 = DJ. | last3 = Baron | first3 = JA. | last4 = Batts | first4 = KP. | last5 = Burke | first5 = CA. | last6 = Burt | first6 = RW. | last7 = Goldblum | first7 = JR. | last8 = Guillem | first8 = JG. | last9 = Kahi | first9 = CJ. | title = Serrated lesions of the colorectum: review and recommendations from an expert panel. | journal = Am J Gastroenterol | volume = 107 | issue = 9 | pages = 1315-29; quiz 1314, 1330 | month = Sep | year = 2012 | doi = 10.1038/ajg.2012.161 | PMID = 22710576 }}</ref>
*The WHO requires - depending on what you read:
*The WHO requires - depending on what you read:
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