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* Context.--Nodular gastric antral vascular ectasia (GAVE) is a reported phenotype of GAVE that has histologic features overlapping with gastric hyperplastic polyps (GHPs), with additional features often seen in flat mucosa of GAVE. Objective.--To determine if nodular GAVE and GHPs are distinct lesions by evaluating the prevalence of features reported in nodular GAVE in GHPs with or without associated GAVE. Design.--A review of all lesions diagnosed as GHPs between 2014 and 2017 was performed. Slides were analyzed for a number of features including established histologic features of GAVE without knowledge of clinical or endoscopic features. Results.--A total of 90 polyps were analyzed including 18 from patients with GAVE (20%). GAVE polyps were larger than non-GAVE polyps (average size, 1.3 cm versus 0.68 cm; P Conclusions.--Nodular GAVE appears to represent GHPs arising in a background of GAVE, with superimposed features found in flat mucosa of GAVE stomachs. The presence of fibrin thrombi, marked vascular ectasia, fibrohyalinosis, and/or ulceration in a GHP is suggestive but not diagnostic of GAVE, and the absence of these features does not rule out GAVE. doi: 10.5858/arpa.2022-0230-OA, Gastric antral vascular ectasia (GAVE) is an acquired vascular abnormality of unknown pathogenesis. (1) Patients with GAVE commonly present either for screening esophagogastroduodenoscopy or with a history of occult gastrointestinal [...]

Characteristic but rare vascular neoplasms in the adult liver composed of small vessels with an infiltrative border were collected from an international group of collaborators over a 5-year period (N=17). These tumors were termed hepatic small vessel neoplasm (HSVN), and the histologic differential diagnosis was angiosarcoma (AS). The average age of patients was 54years (range, 24-83years). HSVN was more common in men. The average size was 2.1cm (range, 0.2-5.5cm). Diagnosis was aided by immunohistochemical stains for vascular lineage (CD31, CD34, FLI-1), which were uniformly positive in HSVN. Immunohistochemical stains (p53, c-Myc, GLUT-1, and Ki-67) for possible malignant potential are suggestive of a benign/low-grade tumor. Capture-based next-generation sequencing (using an assay that targets the coding regions of more than 500 cancer genes) identified an activating hotspot GNAQ mutation in 2 of 3 (67%) tested samples, and one of these cases also had a hotspot mutation in PIK3CA. When compared with hepatic AS (n=10) and cavernous hemangioma (n=6), the Ki-67 proliferative index is the most helpful tool in excluding AS, which demonstrated a tumor cell proliferative index greater than 10% in all cases. Strong p53 and diffuse c-Myc staining was also significantly associated with AS but not with HSVN or cavernous hemangioma. There have been no cases with rupture/hemorrhage, disseminated intravascular coagulation, or Kasabach-Merritt syndrome. Thus far, there has been no metastasis or recurrence of HSVN, but complete resection and close clinical follow-up are recommended because the outcome remains unknown.

A clinical trial carried out to observe the safety and efficiency of folic acid supplements to prevent colorectal adenomas is presented. Its result states that it does not reduce the risk but increase the risk of having colorectal adenomas.

Low-doses of aspirin may prevent colorectal cancer from getting worse, according to a study of 1,121 patients who had recently been diagnosed with colorectal tumors. The progression of the cancer was slower in patients who took 81 milligrams of aspirin, compared to the patients who took 325 milligrams of aspirin or a placebo.

Fecal occult blood screening every year or every two years may reduce the incidence of colorectal cancer, according to a study of 46,551 people. In the groups that were screened every one or two years, the incidence of colorectal cancer was about 20% lower during an 18-year follow-up. This probably occurs because people who test positive have precancerous polyps removed.

It appears that taking supplemental beta carotene and vitamins A and D does not help prevent colorectal adenoma. Colorectal adenoma is a precursor of cancer of the bowels, which is less common in people with diets that include antioxidant vitamin-rich foods such as vegetables and fish. Different combinations of a placebo, beta carotene, and vitamins A and D were given to 751 people who had previously had an adenoma removed. After four years, plasma levels of beta carotene had risen in the group receiving beta carotene supplements, and vitamin C and D levels rose in the groups receiving those vitamins. The incidences of colorectal adenoma were similar in all groups, suggesting that beta carotene and vitamins A and D do not provide added protection against cancer.

Annual screening for colorectal cancer with a fecal occult blood test could reduce mortality from the disease by 33%. Of 46,551 men and women between 50 and 80 years old, approximately 15,000 were screened annually, 15,000 were screened every two years and 15,000 were never screened. Those who had a positive test were referred for colonoscopy. They were followed for 13 years. Over the years the incidence of colorectal cancer was approximately the same in all three groups. However, after 13 years, the mortality rate in the annually screened individuals had dropped 33%. In addition, only 33% had advanced Dukes' stage D cancer, while 65% of those who were never screened had Dukes' stage D cancer. The five-year survival rate in individuals with Dukes' stage D cancer was only 2.4%, compared to survival rates of 94.3% to 56.6% in those with Dukes' stages A through C, respectively.