Colorectal polyp: Difference between revisions
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*Mucin-rich type: Serrated (“saw tooth”) appearance, containing glands with star-shaped lumina.<ref name=Stanford>{{cite web|url=http://surgpathcriteria.stanford.edu/gitumors/colorectal-hyperplastic-polyp/|title=Hyperplastic Polyp of the Colon and Rectum|author=Robert V Rouse|website= | *Mucin-rich type: Serrated (“saw tooth”) appearance, containing glands with star-shaped lumina.<ref name=Stanford>{{cite web|url=http://surgpathcriteria.stanford.edu/gitumors/colorectal-hyperplastic-polyp/|title=Hyperplastic Polyp of the Colon and Rectum|author=Robert V Rouse|website=Stanford University School of Medicine|date=2010-01-31}} Last updated 6/2/2015</ref> Crypts that are elongated but straight, narrow and hyperchromatic at the base. All crypts reach to the muscularis mucosae.<ref name=Stanford/> | ||
*Goblet cell-rich type: Elongated, fat crypts and little to no serration. Filled with goblet cells, extending to surface, which commonly has a tufted appearance.<ref name=Stanford/> | *Goblet cell-rich type: Elongated, fat crypts and little to no serration. Filled with goblet cells, extending to surface, which commonly has a tufted appearance.<ref name=Stanford/> | ||
| [[File:Hyperplastic Polyp of the Rectum (14060044206).jpg|180px]] | | [[File:Hyperplastic Polyp of the Rectum (14060044206).jpg|180px]] | ||
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! Tubular adenoma | ! Tubular adenoma | ||
| '''2%''' at 1.5cm<ref>{{cite web|url=https://www.msdmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gastrointestinal-tract/polyps-of-the-colon-and-rectum|title=Polyps of the Colon and Rectum|author=Minhhuyen Nguyen|website= | | '''2%''' at 1.5cm<ref>{{cite web|url=https://www.msdmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gastrointestinal-tract/polyps-of-the-colon-and-rectum|title=Polyps of the Colon and Rectum|author=Minhhuyen Nguyen|website=MSD Manual}} Last full review/revision June 2019</ref> || Over 75% of volume has tubular appearance.<ref name=WHO>{{cite book | last=Bosman | first=F. T. | title=WHO classification of tumours of the digestive system | publisher=International Agency for Research on Cancer | publication-place=Lyon | year=2010 | isbn=92-832-2432-9 | oclc=688585784 | ref=harv}}</ref> | ||
|- | |- | ||
! Tubulovillous adenoma | ! Tubulovillous adenoma | ||
Revision as of 10:48, 27 September 2019
Author:
Mikael Häggström [note 1]
Gross examination
Tissue selection and trimming
Depending on sample format:[1]
- Biopsies and polyps of <4 mm are embedded in their entirety.
- Small are embedded in their entirety.
- Polyps 4-8 mm with short stem or without stem: Identify the excision surface and divide the polyp longitudinally through the excision surface.
- Polyps > 8 mm with a stem long enough to make it possible to take a transverse, whole slice from the stem closest to the excision surface: First, take a transverse slice through the peripheral portion of the stem, encompassing the entire circumference. Then take a 3-4 mm thick slice longitudinally through the polyp and the middle of the stem, after which the two remaining parts on either side are cut into equally thick slices, parallel to the previous slice.
- Polyps >8 mm with short stem or without stem: Identify the excision surface and cut out a 3-4 mm thick disk that extends longitudinally through the center of the excision surface. Then divide the two remaining portions into equally thick slices, parallel to the previous slice.
- Polyps that come in parts. Pick out the largest pieces, which are cut as similar as possible to above. Small fragments are sieved and embedded in a separate box.
Gross report
Microscopic evaluation
Consider at least the following conditions:
| Type | Risk of containing malignant cells | Histopathology | Image |
|---|---|---|---|
| Hyperplastic polyp | 0% |
|
File:Hyperplastic Polyp of the Rectum (14060044206).jpg |
| Tubular adenoma | 2% at 1.5cm[3] | Over 75% of volume has tubular appearance.[4] | |
| Tubulovillous adenoma | 20% to 25%[5] | 25%-75% villous[4] | |
| Villous adenoma | 15%[6] to 40%[5] | Over 75% villous[4] | |
| Sessile serrated adenoma (SSA)[7] |
|
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Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg (1997-02-13). Lilla utskärningen.
- ↑ 2.0 2.1 2.2 Robert V Rouse (2010-01-31). Hyperplastic Polyp of the Colon and Rectum. Stanford University School of Medicine. Last updated 6/2/2015
- ↑ Minhhuyen Nguyen. Polyps of the Colon and Rectum. MSD Manual. Last full review/revision June 2019
- ↑ 4.0 4.1 4.2 Bosman, F. T. (2010). WHO classification of tumours of the digestive system . Lyon: International Agency for Research on Cancer. ISBN 92-832-2432-9. OCLC 688585784.
- ↑ 5.0 5.1 Amersi, Farin; Agustin, Michelle; Ko, Clifford Y (2005). "Colorectal Cancer: Epidemiology, Risk Factors, and Health Services ". Clinics in Colon and Rectal Surgery 18 (03): 133–140. doi:. ISSN 1531-0043.
- ↑ Alnoor Ramji. Villous Adenoma Follow-up. Medscape. Updated: Oct 24, 2016
- ↑ Rosty, C; Hewett, D. G.; Brown, I. S.; Leggett, B. A.; Whitehall, V. L. (2013). "Serrated polyps of the large intestine: Current understanding of diagnosis, pathogenesis, and clinical management ". Journal of Gastroenterology 48 (3): 287–302. doi:. PMID 23208018.
Image sources