Clinical and histopathological features of colorectal sessile serrated adenoma/polyp and its differential diagnosis
10.3760/cma.j.issn.0529-5807.2014.09.004
- VernacularTitle:结直肠无蒂锯齿状腺瘤／息肉的临床病理特征
- Author:
Yunjin WU
1
;
Haodong XU
;
Hailong ZHU
;
Xuyou ZHU
;
Jun LIANG
;
Yu ZENG
;
Suxia ZHANG
;
Xianghua YI
Author Information
1. 200065,同济大学附属同济医院 上海市同济医院病理科
- Keywords:
Colorectal neoplasms;
Sessile serrated adenoma/polyp;
Colonic Polyps
- From:
Chinese Journal of Pathology
2014;(9):588-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinicopathological characteristics of colorectal sessile serrated adenoma/polyp ( SSA/P) and its differential diagnosis from other serrated lesions. Methods Clinicopathological features of all cases of colorectal serrated lesions from 5 209 colorectal biopsy samples at Shanghai Tongji Hospital from 2008 to 2013 were reviewed.Three hundred and fifty-three cases of serrated lesions were erolled in the study .Morphological features of SSA/P were investigated with an emphasis on histologic criteria for diagnosis and a literature review was performed.Results Three hundred and fifty-three cases of serrated lesions were identified , including 25 SSA/P ( 7.1%) , 278 hyperplastic polyp ( HP, 78.8%) , and 44 traditional serrated adenoma ( TSA, 12.5%).Twenty-five patients with SSA/P consisted of 16 males and 9 females with a mean age of 62.2 years ( aged 34-84 years ) and the lesions involved sigmoid colon (14 cases), ascending colon (9 cases), rectum (1 case) and transverse colon (1 case).Grossly, the majority of SSA/P was sessile with an averaged size of 0.73 cm.Histologically, typical SSA/P had elongated crypts with prominent serration and distorted crypts architecture.The detection rates of crypts dilatation and branching in SSA/P and HP were 100% ( 25/25 ) and 24% ( 12/50, P <0.01 ) , 72%(18/25) and 4%(2/50, P<0.01), respectively.Morphological features observed only in SSA/P included L-shaped crypts ( 48%, 12/25 ) , pseudo infiltration of mucosa muscle ( 16%, 4/25 ) , atypical nuclei (32%, 8/25), and increased mucus secretion (24%, 6/25).Conclusions SSA/P microscopically shows prominent serration and abnormal architectures of crypts.Complete tissue sectioning and correct embedding are helpful for the diagnosis.SSA/P without cytological dysplasia should be distinguished from HP, especially those with only a few distorted crypts .
