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Difference between revisions of "Sessile serrated adenoma"
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Sessile serrated adenoma (view source)
Revision as of 21:51, 27 November 2018
, 21:51, 27 November 2018ref tags
m (patterns of dysplasia; WHO 2019 likely to required just 1 crypt) |
m (ref tags) |
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*Horizontal crypts = crypt long axis parallel to the muscularis mucosae. | *Horizontal crypts = crypt long axis parallel to the muscularis mucosae. | ||
*Crypt branching. | *Crypt branching. | ||
*Submucosal [[lipoma]] or pseudolipoma is often seen in associated with SSA.{{fact}} | |||
*Perineuriomas are also seen in a small proportion of cases | |||
Minimal extent criteria - number of abnormal crypts with the above features: | Minimal extent criteria - number of abnormal crypts with the above features: | ||
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**The 5th edition is likely to make a single crypt sufficient for diagnosis. | **The 5th edition is likely to make a single crypt sufficient for diagnosis. | ||
===Dysplasia=== | ===Dysplasia=== | ||
Sessile serrated adenomas typically lack "conventional" nuclear atypia, as seen in adenomata in the tubulovillous spectrum. | Sessile serrated adenomas typically lack "conventional" nuclear atypia, as seen in adenomata in the tubulovillous spectrum. They are nonetheless neoplastic lesions on account of architectural "dysplasia". Additionally, dysplasia may manifest in more than one way: | ||
;Intestinal or "cytological" dysplasia: As seen in conventional adenomata, i.e. nuclear hyperchromasia and crowding. SSAs with nuclear atypia may be referred to as ''advanced sessile serrated adenomas'' | ;Intestinal or "cytological" dysplasia: As seen in conventional adenomata, i.e. nuclear hyperchromasia and crowding. SSAs with nuclear atypia may be referred to as ''advanced sessile serrated adenomas'' | ||
;Serrated dysplasia: Round nuclei, prominent nucleoli and eosinophilic cytoplasm | ;Serrated dysplasia: Round nuclei, prominent nucleoli and eosinophilic cytoplasm | ||
;Minimal deviation dysplasia: As the name suggests, there is only minor architectural and cytological changes. These areas are associated with loss of MLH1 immunostaining.{{Cite journal | last1 = Liu | first1 = C. | last2 = Walker | first2 = NI. | last3 = Leggett | first3 = BA. | last4 = Whitehall | first4 = VL. | last5 = Bettington | first5 = ML. | last6 = Rosty | first6 = C. | title = Sessile serrated adenomas with dysplasia: morphological patterns and correlations with MLH1 immunohistochemistry. | journal = Mod Pathol | volume = 30 | issue = 12 | pages = 1728-1738 | month = 12 | year = 2017 | doi = 10.1038/modpathol.2017.92 | PMID = 28752838 }} | ;Minimal deviation dysplasia: As the name suggests, there is only minor architectural and cytological changes. These areas are associated with loss of MLH1 immunostaining.<ref name=pmid28752838>{{Cite journal | last1 = Liu | first1 = C. | last2 = Walker | first2 = NI. | last3 = Leggett | first3 = BA. | last4 = Whitehall | first4 = VL. | last5 = Bettington | first5 = ML. | last6 = Rosty | first6 = C. | title = Sessile serrated adenomas with dysplasia: morphological patterns and correlations with MLH1 immunohistochemistry. | journal = Mod Pathol | volume = 30 | issue = 12 | pages = 1728-1738 | month = 12 | year = 2017 | doi = 10.1038/modpathol.2017.92 | PMID = 28752838 }}</ref> | ||
===DDx=== | ===DDx=== | ||