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Difference between revisions of "Gastrointestinal tract polyps"
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Gastrointestinal tract polyps (view source)
Revision as of 19:29, 22 March 2013
, 19:29, 22 March 2013→Traditional adenoma
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===General=== | ===General=== | ||
*Most common group of ''adenomas'' in | *Most common group of ''adenomas'' in gastrointestinal tract. | ||
*Usually arise in the context of an ''APC'' mutation. | |||
*Many are seen in the context of [[familial adenomatous polyposis]]. | |||
===Microscopic=== | ===Microscopic=== | ||
#Nuclear changes at the surface (of the mucosa) - '''key feature'''. | #Nuclear changes at the surface (of the mucosa) - '''key feature'''. | ||
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**[http://media.daveproject.org/media/images/pathology_img/fullsize/gsraju-flat_lession_emr-path.jpeg TA with HGD (daveproject.org)].<ref>URL: [http://daveproject.org/colon-cancer-prevention-flat-lesion-and-endoscopic-mucosal-resection/2011-06-10/ http://daveproject.org/colon-cancer-prevention-flat-lesion-and-endoscopic-mucosal-resection/2011-06-10/]. Accessed on: 24 August 2012.</ref> | **[http://media.daveproject.org/media/images/pathology_img/fullsize/gsraju-flat_lession_emr-path.jpeg TA with HGD (daveproject.org)].<ref>URL: [http://daveproject.org/colon-cancer-prevention-flat-lesion-and-endoscopic-mucosal-resection/2011-06-10/ http://daveproject.org/colon-cancer-prevention-flat-lesion-and-endoscopic-mucosal-resection/2011-06-10/]. Accessed on: 24 August 2012.</ref> | ||
===Typing=== | ====Typing==== | ||
Subclassified as:<ref name=pbod860>{{Ref PBoD|860}}</ref> | Subclassified as:<ref name=pbod860>{{Ref PBoD|860}}</ref> | ||
*''Tubular adenoma'' (most common), tubular component >75%. | *''Tubular adenoma'' (most common), tubular component >75%. | ||
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*The term ''tubular adenoma'' is used in different contexts; it should not be confused with [[Sertoli cell nodule]] ([[AKA]] ''testicular tubular adenoma''). | *The term ''tubular adenoma'' is used in different contexts; it should not be confused with [[Sertoli cell nodule]] ([[AKA]] ''testicular tubular adenoma''). | ||
===Grading=== | ====Grading==== | ||
Adenomas are usually graded with a two-tier system:<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> | Adenomas are usually graded with a two-tier system:<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> | ||
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*[http://commons.wikimedia.org/wiki/File:Tubular_adenoma_high_mag.jpg Tubular adenoma, negative for high-grade dysplasia - high mag. (WC)]. | *[http://commons.wikimedia.org/wiki/File:Tubular_adenoma_high_mag.jpg Tubular adenoma, negative for high-grade dysplasia - high mag. (WC)]. | ||
===Margins=== | ====Margins==== | ||
{{Main|Surgical margins}} | {{Main|Surgical margins}} | ||
*Some pathologists believe it is impossible to determine margins in polypectomies. | *Some pathologists believe it is impossible to determine margins in polypectomies. | ||
*Others comment on what they see and then disclaim based on limitations with something like "... margin clear in plane of section." | *Others comment on what they see and then disclaim based on limitations with something like "... margin clear in plane of section." | ||
===Haggitt classification=== | ====Haggitt classification==== | ||
The ''Haggitt classification'' is a [[staging]] scheme. Surgeons may ask about it 'cause a guy (who probably didn't do a lot of pathology) put it in a widely read surgery textbook. | The ''Haggitt classification'' is a [[staging]] scheme. Surgeons may ask about it 'cause a guy (who probably didn't do a lot of pathology) put it in a widely read surgery textbook. | ||
In short:<ref>URL: [http://www.ganfyd.org/index.php?title=Haggitt_classification http://www.ganfyd.org/index.php?title=Haggitt_classification]. Accessed on: 19 March 2011.</ref><ref name=pmid4007423>{{Cite journal | last1 = Haggitt | first1 = RC. | last2 = Glotzbach | first2 = RE. | last3 = Soffer | first3 = EE. | last4 = Wruble | first4 = LD. | title = Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. | journal = Gastroenterology | volume = 89 | issue = 2 | pages = 328-36 | month = Aug | year = 1985 | doi = | PMID = 4007423 }}</ref> | In short:<ref>URL: [http://www.ganfyd.org/index.php?title=Haggitt_classification http://www.ganfyd.org/index.php?title=Haggitt_classification]. Accessed on: 19 March 2011.</ref><ref name=pmid4007423>{{Cite journal | last1 = Haggitt | first1 = RC. | last2 = Glotzbach | first2 = RE. | last3 = Soffer | first3 = EE. | last4 = Wruble | first4 = LD. | title = Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. | journal = Gastroenterology | volume = 89 | issue = 2 | pages = 328-36 | month = Aug | year = 1985 | doi = | PMID = 4007423 }}</ref> | ||