Comparison of sessile serrated adenoma (SSA) histopathologic diagnostic criteria and their effect on reclassification rate of microvesicular hyperplastic polyps to SSA

2015 ◽  
Vol 53 (05) ◽  
Author(s):  
C Sumánszki ◽  
R Horváth ◽  
T Micsik ◽  
Z Tulassay ◽  
VÁ Patai
2019 ◽  
Vol 156 (6) ◽  
pp. S-828
Author(s):  
Hassan Ashktorab ◽  
Priyanka Kanth ◽  
Nazli Atefi ◽  
Saman Azam ◽  
Babak Shokrani ◽  
...  

2017 ◽  
Vol 05 (08) ◽  
pp. E769-E774 ◽  
Author(s):  
Yushi Ogawa ◽  
Shin-ei Kudo ◽  
Yuichi Mori ◽  
Nobunao Ikehara ◽  
Yasuharu Maeda ◽  
...  

Abstract Background and study aims Recent studies that used magnifying chromoendoscopy and endocytoscopy (EC) to investigate endoscopic features of sessile serrated adenoma/polyps (SSA/Ps) suggested that a dilated crypt opening was an important indicator of SSA/Ps. However, no studies to date have measured the actual extent of dilatation. Hence, we investigated retrospectively the luminal areas using EC to determine a cutoff value for differentiating SSA/Ps from hyperplastic polyps (HPs). Patients and methods A total of 101 lesions, including 25 SSA/Ps, 66 HPs, and 10 normal mucosal samples, assessed by an integrated-type EC were collected. For each lesion, 1 image that showed the widest lumen was selected and the average area of the contiguous 3 lumens were calculated. The cutoff value differentiating SSAPs from HPs was determined by receiver operating curve (ROC) analysis. Results The mean luminal areas of SSA/Ps and HPs were 4152 μm2 and 2117 μm2, respectively. ROC analysis found that a luminal area cutoff of 3068 μm2 had a sensitivity of 80.0 %, a specificity of 77.3 %, an accuracy of 78.0 %, and an area under the ROC curve of 0.865. Furthermore, a cutoff of ≥ 556 μm2 was found to accurately distinguish between HPs and normal mucosa (sensitivity 98.5 %, specificity 100 %, accuracy 98.7 %, and AUC 0.998). Conclusions EC analysis of the luminal area is useful for differentiating between SSAPs and HPs. This approach could be adapted for computer-aided diagnosis of SSA/P.


2016 ◽  
Vol 28 (2) ◽  
pp. 147-154
Author(s):  
Toshihiro KIHARA ◽  
Yutaro KUBOTA ◽  
Kazuo KONISHI ◽  
Atsushi KATAGIRI ◽  
Takashi MURAMOTO ◽  
...  

2014 ◽  
Vol 27 (3) ◽  
pp. 304 ◽  
Author(s):  
Catarina Fidalgo ◽  
Liliana Santos ◽  
Isadora Rosa ◽  
Ricardo Fonseca ◽  
Pedro Lage ◽  
...  

<p><span style="font-family: Times New Roman; font-size: small;"><strong>Introduction:</strong> The World Health Organization reviewed the classification for serrated colonic polyps in 2010. A new entity, sessile serrated adenoma, was included with two variants: with and without cytological dysplasia. This lesion’s malignant potential has been recognized and according to the new classification, many polyps may be reclassified. The impact of this change is yet to be assessed.<br /><strong>Objective:</strong> Analyze the proportion of lesions that were reclassified according to the new World Health Organization classification and the variables that influenced it.<br /><strong>Material and Methods:</strong> Every patient with at least one sessile serrated adenoma diagnosed in a 5 year period was included. All polyps (regardless of type) resected during the study period were reviewed. Data concerning polyp’s characteristics and patient variables were collected. Forty consecutive patients were included [13 female, mean age at 1st sessile serrated adenoma -59 yrs (34-80)].<br /><strong>Results:</strong> Were reviewed 247 polyps: hyperplastic - 42%; conventional adenomas - 29%; sessile serrated adenoma - 24%; serrated adenomas - 5%. Sixty-three polyps were reclassified: 43 hyperplastic, 12 serrated adenomas, 7 sessile serrated adenoma and 1 conventional adenoma with low grade dysplasia. Reclassification was significantly greater for hyperplastic polyps when compared with the other subtypes. Forty-three of one hundred and four (41%) hyperplastic polyps were reclassified all as sessile serrated adenoma. In these polyps the probability of reclassification was independent from polyp location but was greater if polyp size ≥ 5 mm.<br /><strong>Discussion: </strong>This is a single center, rectrospective study. The fact that it was done in an Oncology Referral Institution with a Family Risk Clinic may have influenced the results. Nevertheless the impressive reclassification rate for Hyperplastic Polyps and the fact that they were reclassified mainly as Serrated Adenomas makes these results relevant to daily practice.<br /><strong>Conclusion:</strong> Our results suggest that, according to the new World Health Organization classification for serrated colonic polyps, a considerable proportion of hyperplastic polyps will be reclassified. The serrated pathway of colorectal carcinogenesis has probably been underestimated and at-risk patients may have been under inappropriate surveillance.<br /><strong>Keywords: </strong>Colonic Neoplasms/diagnosis; Colonic Polyps/classification; World Health Organization; Neoplasm Grading.</span></p>


2019 ◽  
Author(s):  
Hassan Ashktorab ◽  
Saman Azam ◽  
Taraneh Tarjoman ◽  
Priyanka Kanth ◽  
Edward Lee ◽  
...  

2011 ◽  
Vol 35 (9) ◽  
pp. 1274-1286 ◽  
Author(s):  
Kyoung-Mee Kim ◽  
Eui Jin Lee ◽  
Sangyun Ha ◽  
So Young Kang ◽  
Kee-Taek Jang ◽  
...  

2016 ◽  
Vol 140 (10) ◽  
pp. 1079-1084 ◽  
Author(s):  
Eun-Young Karen Choi ◽  
Henry D. Appelman

This article offers a historical perspective on the discovery of 3 types of serrated colorectal polyps recognized in the past 60 years. The first to be discovered was the hyperplastic polyp, which is still the most commonly encountered serrated polyp. In the past 20 years, the carcinoma-associated sessile serrated adenoma/polyp has been recognized, but its diagnosis can be difficult owing to overlapping histologic features with hyperplastic polyps. Less is known about the third type, the traditional serrated adenoma, because it is far less common than the other 2 types, and its association with cancer is currently under investigation.


2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S109-S110
Author(s):  
Bradie Bishop ◽  
David Lynch ◽  
Robert Brady

Abstract Langerhans cell histocytosis, otherwise known as eosinophilic granuloma, is a rare neoplastic process composed of Langerhans cells and eosinophils. Most cases present during childhood, with the bones and skin being the most common organs involved. Other organs are occasionally involved, with some systemic cases involving the gastrointestinal tract. Presentations of Langerhans cell histocytosis range from single-organ involvement to systemic involvement. Fewer than five cases of isolated Langerhans cell histocytosis in the gastrointestinal system in adults have been reported. We present a case of Langerhans cell histocytosis incidentally discovered during routine colonoscopy in a 67-year-old otherwise healthy woman. Initial colonoscopy performed 7 years prior demonstrated a sessile serrated adenoma, fragments of tubular adenomas, and hyperplastic polyps. Repeat colonoscopy 3 years later demonstrated a sessile serrated adenoma and hyperplastic polyp. Upon repeat colonoscopy 4 years later, the patient had nine subcentimeter polyps. One of the ascending colon polyp fragments demonstrated a well-circumscribed, submucosal nodule of granular pink histocytes with folded to clefted and reniform nuclei. Numerous eosinophils were present in the background. These findings were consistent with Langerhans cell histocytosis. The remaining polyps were a tubular adenoma and hyperplastic polyps. A CT chest/abdomen/pelvis did not demonstrate any evidence of systemic disease. One year postdiagnosis, the patient had not had recurrence of symptoms. Unifocal Langerhans cell histocytosis rarely presents in the gastrointestinal tract of an adult and is believed to have a good prognosis with limited recurrence. The patient is being closely followed for development of systemic disease.


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