Clinicopathological Characteristics of Superficial Type Colorectal Adenomas Obtained by Endoscopic Resection

Colorectal adenomas may be either protruding type or superficial type lesions. To delineate the clinicopathological characteristics of the latter, 153 superficial type adenomas (including the surrounding mucosa) obtained by endoscopic resection were studied morphologically. Superficial type adenomas were defined as flat or flat depressed adenomas with a height of ≤3 mm; histologically, the tubules proliferated horizontally without vertical overlap. The location of tubules in the mucosa was classified as: involvement of the surface layer only (m1), deeper invasion not reaching the muscularis mucosae (m2), or invasion to the muscularis mucosae (m3). The results of analysis indicated: 1) there was no relationship between atypia and size; 2) although macroscopic features (depression, etc.) were associated with the grade of atypia, a closer association was obtained for the location in the mucosa; 3) based on our classification system for tubule location, m2 and m3 adenomas had a significantly higher frequency of depressed type lesions than did m1 lesions; and 4) the height of superficial type adenomas was 295 to 413 μm. Height was lowest in the m3 group followed by, in ascending order, the m2 and m1 groups. These morphological and histological characteristics are expected to contribute to improved diagnosis of superficial type adenomas.

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Videoendoscopy of Colonic Early Cancer

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.1.125 ◽

1995 ◽

Vol 1 (3) ◽

pp. 125-130

Author(s):

Yoshihiro Sakai

Keyword(s):

Endoscopic Resection ◽

Detection Rate ◽

De Novo ◽

Early Cancer ◽

Depressed Type ◽

High Detection Rate ◽

High Detection ◽

Superficial Type

Since January 1982, 275 early colonic carcinomas undergoing total endoscopic resection were studied. Of this series, 234 lesions showed some adenoma components, whereas the remaining 41 lesions lacked adenoma components. Minute carcinomas measuring ≤ 5 mm (21 lesions) were most commonly the hemispheric protruding type lesions (IIs, 9 lesions), followed by superficial protruding type lesions with a height of ≤ 3 mm (IIa, 6 lesions). There also were 2 superficial depressed-type lesions that were slightly concave. Eight of these minute carcinomas may have developed by de novo carcinogenesis, and 2 had already invaded the submucosa. Therefore every effort should be made not to overlook lesions measuring ≤ 5 mm in diameter. That none of these lesions were located in the rectum indicates the acute necessity for improved examination procedures. With regard to IIa lesions measuring > 5 mm, 92.3% were discovered by videoendoscopy. This high detection rate was attributed to the growing use of videoendoscope systems and reflects heightened interest on the part of endoscopists in superficial type lesions.

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Clinicopathological and Endoscopic Features of Raspberry-Shaped Gastric Cancer in Helicobacter pylori-Uninfected Patients

Digestion ◽

10.1159/000511907 ◽

2020 ◽

pp. 1-8

Author(s):

Noboru Yatagai ◽

Hiroya Ueyama ◽

Muneo Ikemura ◽

Ryota Uchida ◽

Hisanori Utsunomiya ◽

...

Keyword(s):

Gastric Cancer ◽

Gastric Adenocarcinoma ◽

Submucosal Tumor ◽

Clinicopathological Characteristics ◽

Fundic Gland ◽

Histopathological Classification ◽

Histological Characteristics ◽

Greater Curvature ◽

H Pylori ◽

Tumor Shape

Background: Gastric adenocarcinoma of foveolar type (GA-FV) is a raspberry-shaped gastric cancer (RSGC) and garners much attention as H. pylori (Hp)-uninfected gastric cancer. However, the classification and clinicopathological and endoscopic features of RSGCs in Hp-uninfected patients are poorly defined. We designed a new histopathological classification of RSGC and compared them via endoscopic and clinicopathological characteristics. Summary: From 996 patients with early gastric cancers resected by endoscopy in our hospital, we studied 24 RSGC lesions from 21 (2.4%) Hp-uninfected patients. RSGCs were classified into 3 histological types as follows: GA-FV (n = 19), gastric adenocarcinoma of fundic gland type (GA-FG, n = 2), and gastric adenocarcinoma of fundic gland mucosa type (GA-FGM, n = 3). Most of the lesions were found at the greater curvature of the upper or middle third of the stomach. GA-FV lesions were homogeneously reddish and frequently accompanied with a whitish area around the tumor and an irregular microvascular (MV) pattern; these features were confirmed histopathologically by the presence of homogeneous neoplastic foveolar epithelium with foveolar hyperplasia around the tumors. GA-FG lesions might be heterogeneously reddish with a submucosal tumor shape and regular MV pattern; these were confirmed by the presence of covered or mixed nonneoplastic epithelium on deeper regions of tumors. GA-FGM lesions might be homogeneously reddish and occasionally had a submucosal tumor shape and irregular MV pattern; these were confirmed by the presence of homogeneous neoplastic foveolar epithelium on deeper regions of the tumors. Key Messages: RSGCs in Hp-uninfected patients are classified into 3 histopathological types. For accurate diagnosis of RSGCs, it may be necessary to fully understand endoscopic features of these lesions based on these histological characteristics and to take a precise biopsy.

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