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Mucin‐rich variant of traditional serrated adenoma: a distinct morphological variant
- Source :
- Histopathology. 71(2)
- Publication Year :
- 2017
-
Abstract
- Aims Traditional serrated adenomas (TSAs) account for 5% of serrated polyps, and have a villiform architecture, eosinophilic cells with a brush border, and indented, flat‐topped luminal serrations. However, some are composed of mucin‐filled goblet cells (GCs): mucin‐rich TSA (MrTSA). The aim of this study was to determine whether this variant has unique features as compared with classic TSA (cTSA). Methods and results One hundred and fifty‐six TSAs were retrieved from the period 2010–2016. Patient demographics, site of polyps and 16 microscopic variables were evaluated. TSAs containing ≥50% GCs were classified as MrTSAs. Ectopic crypt foci (ECFs) were quantified as low (1–10) or high (>10), counted at ×200 magnification, and the average was taken for 10 fields. Twenty‐four fulfilled the criteria for MrTSA. In males, MrTSAs (65%) were more prevalent than cTSAs (55%). There was no age difference, and both variants had a predilection for the left colon, although, in the right colon, MrTSAs were more frequent (39%) than cTSAs (10%) (P=0.012). Adenomatous dysplasia was present in four of 24 MrTSAs (low grade, 3; high grade, 1). The most distinctive features of MrTSAs were: a variable growth pattern [endophytic (9%), mixed (30%), or villiform/exophytic (61%)], and a lower frequency of ECFs(P=0.001) and more intraepithelial lymphocytes (P95% GCs). Conclusions MrTSA is characterized by >50% GCs, and fewer ECFs than cTSA, but with preservation of archetypal luminal serrations. Awareness of this variant will prevent misdiagnosis, given the association of TSA with the accelerated pathway to colorectal cancer.
- Subjects :
- Adenoma
Adult
Male
Pathology
medicine.medical_specialty
Histology
Colorectal cancer
Crypt
Colonic Polyps
Pathology and Forensic Medicine
Traditional serrated adenoma
03 medical and health sciences
0302 clinical medicine
Eosinophilic
Humans
Medicine
Aged
Aged, 80 and over
business.industry
Mucin
Mucins
General Medicine
Middle Aged
medicine.disease
Dysplasia
030220 oncology & carcinogenesis
Intraepithelial lymphocyte
Female
030211 gastroenterology & hepatology
Colorectal Neoplasms
business
Subjects
Details
- Language :
- English
- ISSN :
- 13652559 and 03090167
- Volume :
- 71
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Histopathology
- Accession number :
- edsair.doi.dedup.....04d91f0e6fec6499244be88f4639d9d0