Gastric serrated adenomas are histologically characterized by protruding glands with lateral saw tooth-like indentations lined with stratified dysplastic cells containing abundant eosinophilic cytoplasm.Since the firs...Gastric serrated adenomas are histologically characterized by protruding glands with lateral saw tooth-like indentations lined with stratified dysplastic cells containing abundant eosinophilic cytoplasm.Since the first case of gastric serrated adenoma found in 2001,18 additional cases have been reported.Gastric serrated adenomas have a particular proclivity to progress to invasive carcinoma;75% or 15 of the 20 cases now in record-including the present one-exhibited invasive carcinoma.The 20 th case of gastric serrated adenoma reported here differs from the preceding ones in as much as it evolved in a patient with Lynch syndrome,implying that this adenoma phenotype may develop not only sporadically but also in patients with hereditary traits.展开更多
The colorectal mucosa includes two quantitatively, structurally and functionally dissimilar areas: one, built with columnar and goblet cells, covers the vast majority of the mucosa, and the other consists of scattered...The colorectal mucosa includes two quantitatively, structurally and functionally dissimilar areas: one, built with columnar and goblet cells, covers the vast majority of the mucosa, and the other consists of scattered minute gut-associated lymphoid tissue (GALT). The overwhelming majority of colorectal carcinomas evolve in GALT-free mucosal areas and very rarely in GALT aggregates. Remarkably, the colonic mucosa in patients with ulcerative colitis (UC) displays a high number of newly formed GALT-aggregates. The patient here described is a 68-year-old female with a history of UC since 1984. At surveillance colonoscopy in 2012, one of two detected polyps was a tubular adenoma with high-grade dysplasia. Beneath this adenoma, a well-circumscribed GALT sheltering a carcinoma was found. Serial sections revealed no connection between the villous adenomaand the GALT-carcinoma. The GALT-carcinoma here reported seems to have evolved in a newly formed, UC- dependent, GALT complex. This notion is substantiated by the fact that 27% or 4 out of the 15 cases of GALT- carcinomas in the colon reported in the literature (including the present case) evolved in patients with UC.展开更多
Background:Patients with hyperplastic polyposis coli syndrome(HPCS)have a propensity to develop colorectal carcinoma(CRC).Patients and Methods:Details were retrieved from the files of patients attending our hospital b...Background:Patients with hyperplastic polyposis coli syndrome(HPCS)have a propensity to develop colorectal carcinoma(CRC).Patients and Methods:Details were retrieved from the files of patients attending our hospital between 1988 and 2004 who fulfilled the World Health Organization criteria for HPCS.Results:Over a period of 16 years,10 cases of HPCS were identified at our hospital(0.625 cases/year or one case every 1.6 years).A mean of 40.3 hyperplastic polyps per patient were found(range 6-159).Other colorectal lesions were found as follows:two patients each had one mixed polyp;there were 15 serrated adenomas in eight patients;and there were 30 tubular,tubulovillous,or villous adenomas in eight patients.Among the 10 patients with HPCS,seven developed a CRC.Of the four villous adenomas,three were associated with a CRC,but only one of the 15 serrated adenomas was associated with a CRC.The pathway of cancer evolution in HPCS patients remains unresolved.Conclusions:Similarly to our results,a review of the literature indicates a high incidence of CRCs in HPCS patients.These patients are at a high risk of developing a CRC and should therefore receive regular colonoscopic surveillance.展开更多
文摘Gastric serrated adenomas are histologically characterized by protruding glands with lateral saw tooth-like indentations lined with stratified dysplastic cells containing abundant eosinophilic cytoplasm.Since the first case of gastric serrated adenoma found in 2001,18 additional cases have been reported.Gastric serrated adenomas have a particular proclivity to progress to invasive carcinoma;75% or 15 of the 20 cases now in record-including the present one-exhibited invasive carcinoma.The 20 th case of gastric serrated adenoma reported here differs from the preceding ones in as much as it evolved in a patient with Lynch syndrome,implying that this adenoma phenotype may develop not only sporadically but also in patients with hereditary traits.
文摘The colorectal mucosa includes two quantitatively, structurally and functionally dissimilar areas: one, built with columnar and goblet cells, covers the vast majority of the mucosa, and the other consists of scattered minute gut-associated lymphoid tissue (GALT). The overwhelming majority of colorectal carcinomas evolve in GALT-free mucosal areas and very rarely in GALT aggregates. Remarkably, the colonic mucosa in patients with ulcerative colitis (UC) displays a high number of newly formed GALT-aggregates. The patient here described is a 68-year-old female with a history of UC since 1984. At surveillance colonoscopy in 2012, one of two detected polyps was a tubular adenoma with high-grade dysplasia. Beneath this adenoma, a well-circumscribed GALT sheltering a carcinoma was found. Serial sections revealed no connection between the villous adenomaand the GALT-carcinoma. The GALT-carcinoma here reported seems to have evolved in a newly formed, UC- dependent, GALT complex. This notion is substantiated by the fact that 27% or 4 out of the 15 cases of GALT- carcinomas in the colon reported in the literature (including the present case) evolved in patients with UC.
文摘Background:Patients with hyperplastic polyposis coli syndrome(HPCS)have a propensity to develop colorectal carcinoma(CRC).Patients and Methods:Details were retrieved from the files of patients attending our hospital between 1988 and 2004 who fulfilled the World Health Organization criteria for HPCS.Results:Over a period of 16 years,10 cases of HPCS were identified at our hospital(0.625 cases/year or one case every 1.6 years).A mean of 40.3 hyperplastic polyps per patient were found(range 6-159).Other colorectal lesions were found as follows:two patients each had one mixed polyp;there were 15 serrated adenomas in eight patients;and there were 30 tubular,tubulovillous,or villous adenomas in eight patients.Among the 10 patients with HPCS,seven developed a CRC.Of the four villous adenomas,three were associated with a CRC,but only one of the 15 serrated adenomas was associated with a CRC.The pathway of cancer evolution in HPCS patients remains unresolved.Conclusions:Similarly to our results,a review of the literature indicates a high incidence of CRCs in HPCS patients.These patients are at a high risk of developing a CRC and should therefore receive regular colonoscopic surveillance.
