Colonic palyps are one of the most risky factors for colon cancer. The pathology of the specimen obtained by forceps biopsy does not represent the whole specimen of the polyp obtained by polypectomy or surgery in some cases. To evaluate these pathologic differences. we analysed the 39 patients with colonic polyps who underwent forceps biopsy and polypectomy. (continue...)
Biopsy* ; Colon* ; Colonic Neoplasms ; Colonic Polyps* ; Humans ; Pathology ; Polyps ; Surgical Instruments*

OBJECTIVETo investigate clinicopathological characteristics of colorectal sessile serrated adenoma/polyp (SSA/P) and its differential diagnosis from other serrated lesions.

METHODSClinicopathological 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.

RESULTSThree 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).

CONCLUSIONSSSA/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.

Adenoma ; pathology ; China ; Colonic Polyps ; pathology ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia ; Intestinal Polyps ; pathology ; Male ; Polyps ; pathology ; Rectal Neoplasms ; pathology

BACKGROUND/AIMS: Colorectal polyps are a common cause of lower gastrointestinal bleeding in children. Our aim was to study the causes of isolated lower gastrointestinal bleeding and to analyze the characteristics of the colorectal polyps found in our cohort. METHODS: We retrospectively reviewed colonoscopic procedures performed between 2007 and 2015. Children with isolated lower gastrointestinal bleeding were included in the study. RESULTS: A total of 185 colonoscopies were performed for isolated lower gastrointestinal bleeding. The median patient age was 8 years, and 77 patients (41.6%) were found to have colonic polyps. Normal colonoscopy findings were observed and acute colitis was detected in 77 (41.6%) and 14 (7.4%) patients, respectively. Single colonic polyps and 2–3 polyps were detected in 73 (94.8%) and 4 (5.2%) patients with polyps, respectively. Of the single polyps, 69 (94.5%) were juvenile polyps, among which 65 (94.2%) were located in the left colon. CONCLUSIONS: Single left-sided juvenile polyps were the most common cause of isolated lower gastrointestinal bleeding in our study. It was rare to find multiple polyps and polyps proximal to the splenic flexure in our cohort. A full colonoscopy is still recommended in all patients in order to properly diagnose the small but significant group of patients with pathologies found proximal to the splenic flexure.
Child ; Cohort Studies ; Colitis ; Colon ; Colon, Transverse ; Colonic Polyps ; Colonoscopy ; Hemorrhage ; Humans ; Pathology ; Polyps ; Retrospective Studies

Colonoscopic evaluation has revolutionized the management of colorectal disorders, of which colorectal neoplasia is the most important. Experience with 2000 consecutive colonoscopies was reviewed to determine their clinical significance. The symptoms that patients complained about were anal bleeding, abdominal pain, diarrhea, and constipation. Colonic polyps, colon cancer, and ulcerative colitis were diagnosed by colonoscopy. Colonic polyps were the most common pathology for anal bleeding and constipation. Ulcerative colitis was the most common pathology for diarrhea. Intestinal tuberculosis was the most common pathology for abdominal pain. Colon cancer was the most common pathology for tenesmus. Lymphoid hyperplasia was the most common pathology in patients under 10. Ulcerative colitis was the most common pathology in patients in their 3rd or 4th decade. Colonic polyp was the most common pathology in patients in their 5th, 6th, or 7th decade. Colon cancer was the most common pathology in patients in their of 8th or 9th decade. A colonoscopic polypectomy was performed in 49.5% of the colonoscopies, and an open polypectomy was done in 2.7%. There were no surgical complications from the colonoscopies. As a result of this study, it is concluded that total colonoscopic examination should be performed in patients over 40 who complain about rectal bleeding and tenesmus. To avoid complications and give proper management, it is recommended that colonoscopy be performed by a surgeon.
Abdominal Pain ; Colitis, Ulcerative ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Constipation ; Diarrhea ; Hemorrhage ; Humans ; Hyperplasia ; Pathology ; Tuberculosis

No abstract available.
Adenoma/*diagnosis ; Colonic Neoplasms/*diagnosis ; Colonic Polyps/*pathology ; Female ; Humans ; Male

An unusual localization of localized colitis cystica profunda in a 31-year-old man is described. The patient presented as anal bleeding and a protruding mass at the descending colon; the mass was polypoid and was made up of papillary epithelial hyperplasia with downward herniation of glands into the submucosa. Only one similar case involving a descending colon has been reported in the world literature.
Adult ; Colonic Diseases/complications/*pathology ; Colonic Polyps/complications/*pathology ; Cysts/complications/*pathology ; Humans ; Intestinal Mucosa/pathology ; Male

Narrow-band imaging (NBI) is a new imaging technology that was developed in 2006 and has since spread worldwide. Because of its convenience, NBI has been replacing the role of chromoendoscopy. Here we review the efficacy of NBI with/without magnification for detection, characterization, and management of colorectal polyps, and future perspectives for the technology, including education. Recent studies have shown that the next-generation NBI system can detect significantly more colonic polyps than white light imaging, suggesting that NBI may become the modality of choice from the beginning of screening. The capillary pattern revealed by NBI, and the NBI International Colorectal Endoscopic classification are helpful for prediction of histology and for estimating the depth of invasion of colorectal cancer. However, NBI with magnifying colonoscopy is not superior to magnifying chromoendoscopy for estimation of invasion depth. Currently, therefore, chromoendoscopy should also be performed additionally if deep submucosal invasive cancer is suspected. If endoscopists become able to accurately estimate colorectal polyp pathology using NBI, this will allow adenomatous polyps to be resected and discarded; thus, reducing both the risk of polypectomy and costs. In order to achieve this goal, a suitable system for education and training in in vivo diagnostics will be necessary.
Adenomatous Polyps ; Capillaries ; Classification ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis ; Education ; Mass Screening ; Narrow Band Imaging ; Pathology ; Polyps*

A colonic muco-submucosal elongated polyp (CMSEP) was identified at colonoscopy in a 53-year-old male patient with lower gastrointestinal bleeding. Non-polypoid depressed type of early cancer was noted at the tip of the colonic polyp. The CMSEP is very rare and incidentally found in most cases. Moreover, its association with colonic neoplasia is extremely rare. To our knowledge, this is the second case report of CMSEP associated with a cancerous transformation.
Colonic Neoplasms/*diagnosis/pathology ; Colonic Polyps/*pathology ; Colonoscopy ; Gastrointestinal Hemorrhage ; Humans ; Intestinal Mucosa/*pathology ; Male ; Middle Aged

Colon ; pathology ; Colonic Polyps ; pathology ; Diagnosis, Differential ; Female ; Humans ; Intestinal Mucosa ; pathology ; Male ; Middle Aged

Colonic Neoplasms ; pathology ; Colonic Polyps ; pathology ; Fluorodeoxyglucose F18 ; Humans ; Lymphatic Metastasis ; diagnostic imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Radiography