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Difference between revisions of "Gastrointestinal tract polyps"
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Gastrointestinal tract polyps (view source)
Revision as of 17:05, 10 September 2012
, 17:05, 10 September 2012→Traditional adenoma: comment on submucosa
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COLONIC POLYP, SIGMOID COLON, BIOPSY: | COLONIC POLYP, SIGMOID COLON, BIOPSY: | ||
- TUBULAR ADENOMA WITH HIGH-GRADE DYSPLASIA. | - TUBULAR ADENOMA WITH HIGH-GRADE DYSPLASIA. | ||
</pre> | |||
<pre> | |||
SIGMOID LESION, 25 CM, BIOPSY: | |||
- TUBULAR ADENOMA, NEGATIVE FOR HIGH-GRADE DYSPLASIA, SEE COMMENT. | |||
COMMENT: | |||
No definite submucosa is present; thus, the presence or absence of invasion cannot be assessed. | |||
</pre> | </pre> | ||
Notes: | Notes: | ||
#"Negative for high-grade dysplasia and malignancy" is recommended in the Canadian consensus.<ref name=driman>{{cite journal | last1 = Driman | first1 = DK. | last2 = Marcus | first2 = VA. | last3 = Hilsden | first3 = RJ | last4 = Owen | first4 = DA |title=Pathologic reporting of colorectal polyps: pan-Canadian consensus guidelines |journal=Canadian Journal of Pathology |volume=4 |issue=3 |pages=81-90 |year=2012 |month= |pmid= |doi= |url= }}</ref> The reasoning for the first part is: "with low-grade dysplasia" may lead to over treatment by physicians that are not aware that all (traditional) adenomas have low-grade dysplasia. | #"Negative for high-grade dysplasia and malignancy" is recommended in the Canadian consensus.<ref name=driman>{{cite journal | last1 = Driman | first1 = DK. | last2 = Marcus | first2 = VA. | last3 = Hilsden | first3 = RJ | last4 = Owen | first4 = DA |title=Pathologic reporting of colorectal polyps: pan-Canadian consensus guidelines |journal=Canadian Journal of Pathology |volume=4 |issue=3 |pages=81-90 |year=2012 |month= |pmid= |doi= |url= }}</ref> The reasoning for the first part is: "with low-grade dysplasia" may lead to over treatment by physicians that are not aware that all (traditional) adenomas have low-grade dysplasia. | ||
#The phrase "negative for [...] malignancy" is also recommended in the Canadian consensus. This is not endorsed here, as one very frequently does not get submucosa. It is like reporting "negative for submucosal invasion" on gastric biopsies. Further, they do not advise "negative for dysplasia and malignancy" for [[SSA]]s. | #The phrase "negative for [...] malignancy" is also recommended in the Canadian consensus. This is not endorsed here, as one very frequently does not get submucosa. It is like reporting "negative for submucosal invasion" on gastric biopsies. Further, they do not advise "negative for dysplasia and malignancy" for [[SSA]]s. If there is clinical suspicion of an invasive malignancy, it is useful to comment that no submucosa is present. | ||
==Traditional serrated adenoma== | ==Traditional serrated adenoma== | ||