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Difference between revisions of "Gastrointestinal tract polyps"
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Gastrointestinal tract polyps (view source)
Revision as of 03:29, 26 December 2012
, 03:29, 26 December 2012→Colorectal adenocarcinoma
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===General=== | ===General=== | ||
* | *Diagnosis may be a challenging on a small biopsy. | ||
====Clinical==== | ====Clinical==== | ||
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*Pit pattern.<ref name=pmid18458845>{{Cite journal | last1 = Onishi | first1 = T. | last2 = Tamura | first2 = S. | last3 = Kuratani | first3 = Y. | last4 = Onishi | first4 = S. | last5 = Yasuda | first5 = N. | title = Evaluation of the depth score of type V pit patterns in crypt orifices of colorectal neoplastic lesions. | journal = J Gastroenterol | volume = 43 | issue = 4 | pages = 291-7 | month = | year = 2008 | doi = 10.1007/s00535-008-2161-1 | PMID = 18458845 }}</ref> | *Pit pattern.<ref name=pmid18458845>{{Cite journal | last1 = Onishi | first1 = T. | last2 = Tamura | first2 = S. | last3 = Kuratani | first3 = Y. | last4 = Onishi | first4 = S. | last5 = Yasuda | first5 = N. | title = Evaluation of the depth score of type V pit patterns in crypt orifices of colorectal neoplastic lesions. | journal = J Gastroenterol | volume = 43 | issue = 4 | pages = 291-7 | month = | year = 2008 | doi = 10.1007/s00535-008-2161-1 | PMID = 18458845 }}</ref> | ||
*Non-lifting sign.<ref name=pmid7926542>{{Cite journal | last1 = Uno | first1 = Y. | last2 = Munakata | first2 = A. | title = The non-lifting sign of invasive colon cancer. | journal = Gastrointest Endosc | volume = 40 | issue = 4 | pages = 485-9 | month = | year = | doi = | PMID = 7926542 }}</ref> | *Non-lifting sign.<ref name=pmid7926542>{{Cite journal | last1 = Uno | first1 = Y. | last2 = Munakata | first2 = A. | title = The non-lifting sign of invasive colon cancer. | journal = Gastrointest Endosc | volume = 40 | issue = 4 | pages = 485-9 | month = | year = | doi = | PMID = 7926542 }}</ref> | ||
**Presence predicts deeper invasion.<ref name=pmid10462651>{{Cite journal | last1 = Ishiguro | first1 = A. | last2 = Uno | first2 = Y. | last3 = Ishiguro | first3 = Y. | last4 = Munakata | first4 = A. | last5 = Morita | first5 = T. | title = Correlation of lifting versus non-lifting and microscopic depth of invasion in early colorectal cancer. | journal = Gastrointest Endosc | volume = 50 | issue = 3 | pages = 329-33 | month = Sep | year = 1999 | doi = 10.1053/ge.1999.v50.98591 | PMID = 10462651 }}</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
One of the following: | |||
*Desmoplastic response - '''key feature'''. | #Usual morphology - features:<ref name=pmid22827760>{{Cite journal | last1 = Kimura | first1 = R. | last2 = Fujimori | first2 = T. | last3 = Ichikawa | first3 = K. | last4 = Ajioka | first4 = Y. | last5 = Ueno | first5 = H. | last6 = Ohkura | first6 = Y. | last7 = Kashida | first7 = H. | last8 = Togashi | first8 = K. | last9 = Yao | first9 = T. | title = Desmoplastic reaction in biopsy specimens of early colorectal cancer: a Japanese prospective multicenter study. | journal = Pathol Int | volume = 62 | issue = 8 | pages = 525-31 | month = Aug | year = 2012 | doi = 10.1111/j.1440-1827.2012.02840.x | PMID = 22827760 }}</ref> | ||
**Spindle cells with large nuclei. | #*Desmoplastic response - '''key feature'''. | ||
***Nuclei ~ size of a plasma cell. | #**Spindle cells with large nuclei. | ||
**Eosinophilic cytoplasm. | #***Nuclei ~ size of a plasma cell. | ||
*Nuclear changes seen in adenomatous polyps. | #**Eosinophilic cytoplasm. | ||
**Enlarged. | #*Nuclear changes seen in adenomatous polyps. | ||
**Chromatin hyperchromatic ''or'' vesicular. | #**Enlarged. | ||
**Round-shap ''or'' cigar-shaped and pseudostratified. | #**Chromatin hyperchromatic ''or'' vesicular. | ||
*Architectural changes - usually those of high-grade dysplasia: | #**Round-shap ''or'' cigar-shaped and pseudostratified. | ||
**Cribriforming. | #*Architectural changes - usually those of high-grade dysplasia: | ||
**Papillary tufting. | #**Cribriforming. | ||
**Budding. | #**Papillary tufting. | ||
#**Budding. | |||
#[[Signet ring cell carcinoma|Signet ring cells]]. | |||
DDx: | DDx: | ||