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Difference between revisions of "Gastrointestinal tract polyps"
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Gastrointestinal tract polyps (view source)
Revision as of 15:03, 13 September 2012
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#"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. If there is clinical suspicion of an invasive malignancy, it is useful to comment that no submucosa is present. | #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. | ||
====Micro==== | |||
=====Tubular-tubulovillous interface===== | |||
The sections shows colorectal-type mucosa with a tubule-forming epithelium that has cellular pseudostratification and enlarged hyperchromatic nuclei, from the crypt base to the luminal aspect (dyplastic). | |||
No cribriforming of glands, epithelial budding or intraluminal papillary tufting is identified. Goblet cells are present in the dysplastic epithelium. Dysplastic nuclei have an ellipsoid-shape and basally stratified. | |||
A small number of rare finger-like epithelial projections (villi) are noted; however these appear to comprise less than 20% of the sampled tissue. It is possible that the villous component is higher, due to sampling error; thus, this could represent a tubulovillous adenoma. | |||
==Traditional serrated adenoma== | ==Traditional serrated adenoma== | ||