The Incidence and Significance of Villous Change in Adenomatous Polyps
|
|
- Brandon Gilmore
- 6 years ago
- Views:
Transcription
1 The Incidence and Significance Villous Change in Adenomatous Polyps CHRISTOPHER H. K. FUNC, M.D., AND HARVEY GOLDMAN, M.D. Department Pathology, Harvard Medical School and Beth Israel Hospital, Boston, Massachusetts Abstract. Fung, Christopher, H. K., and Goldman, Harvey: The incidence and significance villous change in adenomatous polyps. Am. J. Clin. Path. 53: 21-25, A retrospective review 108 colonic adenomatous polyps revealed focal villous change in 6% solitary lesions, 15% polyps with coexisting adenocarcinoma, 33% those with coexisting villous adenoma, and 64% polyps with carcinomatous transformation. However, a subsequent prospective analysis 67 colonic polypoid lesions, using a dissecting microscope and more sections, indicated that the incidence focal villous change had been underestimated. This feature was found in 35% solitary adenomatous polyps and appeared to be directly related to the size the polyps, reaching 75% in lesions larger than 1 cm. in diameter. The dissecting microscopic interpretations provided the correct estimate a villous pattern in 96% cases. Although morphologically the adenomatous polyp with focal villous change appears to represent an intermediate form between the pure adenomatous polyp and the villous adenoma, evidence for obligatory transformation and increased malignant potential this form is inconclusive. The difficulty that may be encountered in the interpretation a villous area in a small biopsy is discussed. A PRECISE histologic distinction between adenomatous polyp is characterized by a adenomatous polyps and villous (or papil- coarsely-lobulated structure with minimal lary) adenomas is desirable in view the or no detectable villous areas, whereas the pronounced difference between the malig- villous adenoma is defined simply by the nant potentials the two forms. Whereas presence a predominant villous or papilthe occurrence carcinoma in adenoma-, i i i i i i, lar >' pa"ern. ligible, tous polyps - s or has at been most considered less than to 1%, be neg- the _.,..,,..,!, i lny i ever, Difficulties have ten in been exact encountered, classification, ' 18 how and recorded incidence malignancy in villous adenomas has ranged from 35 to the possible existence intermediate 7(w.i, io, i3, i4,17 Since no essential differ- forms has been proposed by numerous indices in cytologic detail " 10. 1S or mucin vestigators. 5 - "' " " " 15 The present study, content" have been demonstrated in these which includes observations made with the two lesions, the established criterion for dissecting microscope, was conducted in their separation has been limited to the order to determine the frequency occurdegree villous pattern present. The rence 0f villous areas in various groups adenomatous polyps and to consider these Received lime lfi, 19G9; accepted for publication r, i t. i r - i August ustf. 6, 1009, ifjjjo. i i findings in relation to the genesis vil- 21
2 22 FUNG AND GOLDMAN Vol. 53 Fie. 1. Low-power photomicrograph o adenomatous polyp with focal villous change. The predominant component (left and top) is adenomatous, but a distinct villous area is present on the right. Hematoxylin and eosin. X 12. lous adenomas and to overall malignant potential. Fin. 2. Higher-power view villous area noted in Figure 1. Hematoxylin and eosin. X HO. Material and Methods The study, in which we employed surgical material exclusively, consisted two parts: 1) a retrospective study, in which 108 selected adenomatous polyps the human colon, alone or in association with other lesions, were reviewed, and 2) a prospective study, in which 67 colonic polypoid lesions (including adenomatous polyps, villous adenomas, carcinomas, hyperplastic polyps, 0 inflammatory polyps and mucosal tags) were examined initially with the dissecting microscope. For both, paraffin-embedded sections formal in-fixed tissues were stained with hematoxylin and eosin. Whereas the number sections each polyp available in the retrospective survey was generally one to two, usually more than four sections each lesion in the prospective study were examined. Standard histologic criteria as outlined by Dukes 4 were employed to distinguish the adenomatous and villous areas, and the designations adenomatous polyps
3 January 1970 VILLOUS CHANGE IN ADENOMATOUS POLYPS 23 and villous adenomas depended solely on the predominant pattern present. For each adenomatous polyp, the presence focal villous change, i.e., involving less than half the lesion, was noted as well. Accordingly, pure adenomatous polyps, adenomatous polyps with focal villous change (Figs. 1 and 2), and villous adenomas were recognized. The diagnosis carcinoma within the polyp was determined by the demonstration invasion or extreme cytologic atypicality, usually the former; metastases were not observed in any these cases. Results Retrospective Study. The relative incidences focal villous change observed within the various subgroups adenomatous polyps examined in the retrospective study are listed in Table 1. Villous change appeared to be distinctly more common in cases with carcinoma in the polyp or in those with a coexisting villous adenoma. Prospective Study. The 67 colonic lesions examined with the dissecting microscope were described as villous, leafy, lobulated, cobblestoned, pitted, granular, firm, or mucinous in appearance. Except for the villous pattern, however, there were no consistent histologic counterparts for these features. A precise correlation between the gross impression the presence or absence a villous pattern and the histologic confirmation was achieved in all but three cases (96%). Jn two cases, a villous pattern was anticipated but not confirmed by histologic study, and in one instance, the villous appearance was missed. Adenocarcinoma was suspected in 11 cases on the basis induration or excessively mucinous appearance, but was confirmed in only five; the remaining six lesions, four were villous adenomas and two, inflammatory polyps. In addition, there was one carcinoma arising in a polyp which was not grossly apparent. TABLE 1. Incidence Focal Villous Change in Adenomatous Polyps {Retrospective Study) Number Villous Change Type Lesion Polyps Number % Adenomatous polyps with out associated villous adenoma or carcinoma Adenomatous polyps with coexisting adenocarcinoma the colon Adenomatous polyps with coexisting villous adenoma the colon Adenocarcinoma arising in adenomatous polyps In Table 2, the incidences histologically-demonstrated villous patterns, either focal or more diffuse, are listed for the lesions examined in the prospective study. Comparison with the retrospective study (Table 1) reveals that the occurrence a focal villous area in solitary adenomatous polyps is a common feature (35%) which may be missed in examinations employing random or few sections (6%). Furthermore, TABLE 2. Incidence Villous Pattern in Colonic Polypoid Lesions {Prospective Study) Number Villous Pattern Type Lesion Lesions Number % Adenomatous polyps only Adenomatous polyps with 0 0 coexisting adenocarcinoma colon Adenomatous polyps with 2 2 coexisting villous adenoma colon Adenomatous polyp with 1 1 carcinoma arising in it Villous adenomas Villous adenomas with 2 2 carcinoma arising in them Adenocarcinomas, de novo 3 0 Miscellaneous (hyperplas tic and inflammatory polyps and mucosal tags)
4 24 FUNG AND GOLDMAN Vol. 53 TABLE 3. Relation Focal Villous Change to Size Adenomatous Polyp {Prospective Study) Size Polyp 0-5 mm mm. >10mm. TOTAL Number Polyps Villous Change Number % there appears to be a distinct relation between the size the adenomatous polyp and the presence a focal villous change, as indicated in Table 3. Thus, 75% the solitary adenomatous polyps larger than 1 cm. in diameter exhibited a focal villous area. Discussion The presence focal villous change in otherwise typical adenomatous polyps appears to be common, especially in lesions larger than 1 cm. in diameter. The much higher incidence observed in solitary adenomatous polyps in the prospective study (35%), as compared with the retrospective study (6%), is due in part to the use the dissecting microscope, which clearly aided in the selection the appropriate area for histologic study. In fact, the estimation a villous pattern by the dissecting microscope was accurate in all but three the 67 lesions examined. However, the greater number sections taken routinely in the prospective study may also have contributed to the higher incidence villous change noted, and suggests further that the total incidence this feature may be largely underestimated. The occurrence focal villous change in adenomatous polyps and its relation to the size the lesion have been noted previously. Ferraro and Ross 5 detected villous features in 45% adenomatous polyps, and observed that this was more common in larger polyps and in older age groups. The lower overall incidence 7.5%, noted by Jackman and Beahrs, 7 reflects the small size the majority the polyps examined in that series; it is noteworthy, however, that in polyps larger than 1 cm. in diameter, a villous pattern was found in 43%. This relation to size the polyps is supported by the present study, in which the incidence focal villous change was found to be even greater than that previously recorded. The precise significance focal villous change within an adenomatous polyp has not been established. Thus, the retrospective study revealed an increased incidence focal villous change in adenomatous polyps associated with villous adenomas and carcinomas, as compared with solitary lesions (Table 1). However, in the subsequent prospective study employing adequate and selective sections (Tables 2 and 3), this feature was detected in the majority solitary adenomatous polyps larger than 1 cm. in diameter. Because adenomatous polyps this size are, in general, much more common than villous adenomas, and possess a very low malignant potential, the presence villous change in these polyps must at present be considered to be limited importance as a sign a biologically more significant lesion. Whether the appearance focal villous change represents an abortive attempt at transformation and whether some villous adenomas are derived by successful transformation pre-existing adenomatous polyps cannot be established from the results the present study. In view the apparent difference in behavior between polyps with focal villous change and those with diffuse or predominantly villous patterns, i.e., villous adenomas, an accurate histologic distinction is essential. Ideally, this can be accomplished when the entire lesion is available for study by simply assessing the degree the villous area present. Difficulties, however, may be encountered when small mucosal biopsy specimens are examined.
5 January 1970 VILLOUS CHANGE IN ADENOMATOUS POLYPS 25 Thus, if the biopsy reveals a villous area, it may be derived not only from a villous adenoma but also from an adenomatous polyp with focal villous change. Since from the present study the latter appears to be so common, especially in the larger polyps which may have an initial biopsy before excision, there exists the danger overestimating the significance the villous feature, resulting in an erroneous diagnosis and incorrect therapy. Clearly, the histologic study a biopsy must at all times be correlated with the gross appearance the lesion as viewed by sigmoidoscopy or operative colostomy; if any disparity exists between the gross and microscopic impressions, definitive diagnosis should await examination the entire lesion References 1. Bacon, H. E., Lowell, E. J., Jr., and Trimpi, H. 1).: Villous papillomas the colon and rectum. Surgery, 35: 77-87, Castleman, B., and Krickstein, H.: Do adenomatous polyps o the colon become malignant? New Engl. J. Med., 267: , 1962.!. Castleman, 15., and Krickstein, H.: Carcinoma arising in adenomatous polyps the colon is greatly exaggerated. In lngelfinger, F. J., Relman, A. S., and Finland, M. (eds.): Controversy in Internal Medicine. Philadelphia, W. B. Saunders Co., 1966, pp Dukes, C. E.: An explanation the difference between a papilloma and an adenoma the rectum. Proc. Roy. Soc. Med., 40: , Ferraro, L., and Ross, S.: Evaluation villous patterns in tumors the colon and rectum. Dis. Colon Rectum, 8: , Goldman, H., and Ming, S. C: Mucins in normal and neoplastic gastrointestinal epithelium. Arch. Path., 85: , Jackman, R., and Beahrs, O.: Tumors the Large Bowel. Philadelphia, W. B. Saunders Co., 1968, pp Lane, N., and Kaye, G.: Pedunculated adenomatous polyp the colon with carcinoma, lymph node metastasis, and suture-line recurrence. Am. J. Clin. Path., 48: , Lane, N., and Lev, R.: Observations on the origin adenomatous epithelium the colon. Cancer, 16: , Mackie, J. A., Jr., Miller, L. D., and Fills, W. T., Jr.: Polyps and polypoid lesions the large bowel: Surgical considerations. Surg. Clin. N. Amcr., 42: , Morson, B. C: Precancerous lesions the colon and rectum. J.A.M.A., 179: , Spjut, H. J., and Navarrete, A.: Adenomatous polyps and polyps familial polyposis: A. morphological study the contrasts and similarities. Am. J. Path., 48: 5a-6a, Sunderland, D. A., and Binkley, G. E.: Papillary adenomas the large intestine. Cancer, 1: , Swinton, N. VV., Meissner, W. A., and Soland, W. A., Jr.: Papillary adenomas the colon and rectum. Arch. Int. Med., 96: , Turrell, R., and Haller, J.: A re-evaluation the malignant potential colorectal adenomas. Surg. Gynec. Obslet., 119: , Welch, C. E., McKittrick, J. B., and Rehringer, C: Polyps rectum and colon and their relation to cancer. New Engl. J. Med., 247: , Wheat, M. W., and Ackerman, L. V.: Villous adenomas the large intestine. Ann. Surg., 147: , Wood, D.: Tumors the intestine. Atlas Tumor Pathology, Section VI Fascicle 22. Washington, D. C, Armed Forces Institute Pathology, 1967, pp Requests for reprints should be addressed to: Harvey Goldman, M.D., Department Pathology, Beth Israel Hospital, 330 Brookline Avenue, Boston, Massachusetts
S rectal polyps that show atypia, adenocarcinoma,
HOW RELIABLE IS BIOPSY OF RECTAL POLYPS? A Clinical and Morphological Study of 107 Cases C. ALEXANDER HELLWIG, M.D., AND EDGARD BARBOSA. nr.d. OME OVERLY cautious pathologists call all S rectal polyps
More informationwhat is the alternative mechanism of histogenesis? Aspects of the morphology of the adenomacarcinoma Morphology of the
Refer to: Morson B: Polyps and cancer of the large bowel. West J Med 125:93-99, Aug 1976 THE WESTERN Journal of Miedicine Polyps and Cancer of the Large Bowel BASIL MORSON, MD, London MORTALITY STATISTICS
More informationColon and Rectum: 2018 Solid Tumor Rules
2018 SEER Solid Tumor Manual 2018 KCR SPRING TRAINING Colon and Rectum: 2018 Solid Tumor Rules 1 Colon and Rectum Solid Tumor Rules Separate sections for: Introduction Changes from 2007 MP/H rules Equivalent
More informationCOLON AND RECTUM SOLID TUMOR RULES ABSTRACTORS TRAINING
COLON AND RECTUM SOLID TUMOR RULES ABSTRACTORS TRAINING COLON AND RECTUM SOLID TUMOR RULES Separate sections for: Introduction Changes from 2007 MP/H rules Equivalent Terms Terms that are NOT Equivalent
More informationLarge Colorectal Adenomas An Approach to Pathologic Evaluation
Anatomic Pathology / LARGE COLORECTAL ADENOMAS AND PATHOLOGIC EVALUATION Large Colorectal Adenomas An Approach to Pathologic Evaluation Elizabeth D. Euscher, MD, 1 Theodore H. Niemann, MD, 1 Joel G. Lucas,
More informationRectal biopsy as an aid to cancer control in ulcerative colitis
Rectal biopsy as an aid to cancer control in ulcerative colitis B. C. MORSON AND LILLIAN S. C. PANG From the Research Department, St. Mark's Hospital, London Gut, 1967, 8, 423 EDITORIAL COMMENT This is
More informationClinicopathological Characteristics of Superficial Type
Diagnostic and Therapeutic Endoscopy, 1995, Vol. 2, pp. 99-105 Reprints available directly from the publisher Photocopying permitted by license only (C) 1995 Harwood Academic Publishers GmbH Printed in
More informationPrognosis after Treatment of Villous Adenomas
Prognosis after Treatment of Villous Adenomas of the Colon and Rectum JOHN CHRISTIANSEN, M.D., PREBEN KIRKEGAARD, M.D., JYTTE IBSEN, M.D. With the existing evidence of neoplastic polyps of the colon and
More informationMuco-epidermoid tumours of the anal canal
J. clin. Path. (1963), 16, 200 Muco-epidermoid tumours of the anal canal B. C. MORSON AND H. VOLKSTADT From the Research Department, St. Mark's Hospital, London SYNOPSIS The pathology of 21 cases of muco-epidermoid
More informationIn current practice in surgical pathology, colorectal polyps
Colorectal Polyps With Extensive Absorptive Enterocyte Differentiation Histologically Distinct Variant of Hyperplastic Polyps Hidejiro Yokoo, MD; M. Irtaza Usman, Bsc(Hons); Susan Wheaton, MD; Patricia
More informationpolyps of the colon and rectum
J. clin. Path., 1973, 26, 25-31 Pseudo-carcinomatous invasion in adenomatous polyps of the colon and rectum T. MUTO, H. J. R. BUSSEY, AND B. C. MORSON From St Mark's Hospital, London SYNOPSIS The histology
More informationHyperplastische Polyps Innocent bystanders?
Hyperplastische Polyps Innocent bystanders?? K. Geboes P th l i h O tl dk d Pathologische Ontleedkunde, KULeuven Content Historical Classification Relation Hyperplastic polyps carcinoma The concept cept
More informationIntestinal polyps in the Nigerian African
A. OLUFEMI WILLIAMS AND D. L. PRINCE' J. clin. Path., 1975, 28, 367-371 From the Department ofpathology, University of Ibadan and University College Hospital, Ibadan, Nigeria SYNOPSIS Intestinal polyps
More informationJUVENILE POLYPOSIS COLI.
JUVENILE POLYPOSIS COLI. By G. W. JOHNSTON, M.Ch., F.R.C.S., D. EAKINS, M.D., M.C.Path., A. D. GOUGH, M.B., F.F.R. Royal Victoria Hospital, and Department of Pathology, The Queen's University, Belfast
More informationcolorectal cancer Colorectal cancer hereditary sporadic Familial 1/12/2018
colorectal cancer Adenocarcinoma of the colon and rectum is the third most common site of new cancer cases and deaths in men (following prostate and lung or bronchus cancer) and women (following breast
More informationColonic Polyp. Najmeh Aletaha. MD
Colonic Polyp Najmeh Aletaha. MD 1 Polyps & classification 2 Colorectal cancer risk factors 3 Pathogenesis 4 Surveillance polyp of the colon refers to a protuberance into the lumen above the surrounding
More informationFINAL HISTOLOGICAL DIAGNOSIS: Villo-adenomatous polyp with in-situ-carcinomatous foci (involving both adenomatous and villous component).
SOLITARY VILLO ADENOMATOUS POLYP WITH CARCINOMATOUS CHANGES RECTUM: A Divvya B 1, M. Valluvan 2, Rehana Tippoo 3, P. Viswanathan 4, R. Baskaran 5 HOW TO CITE THIS ARTICLE: Divvya B, M. Valluvan, Rehana
More informationStructure and significance of metaplastic nodules in the rectal mucosa
J. clin. Path. (198), 1, 7-7 Structure and significance of metaplastic nodules in the rectal mucosa J. F. ARTHUR From the Bland-Sutton Institute ofpathology, Middlesex Hospital Medical School, London SYNOPSIS
More informationPatologia sistematica V Gastroenterologia Prof. Stefano Fiorucci. Colon polyps. Colorectal cancer
Patologia sistematica V Gastroenterologia Prof. Stefano Fiorucci Colon polyps Colorectal cancer Harrison s Principles of Internal Medicine 18 Ed. 2012 Colorectal cancer 70% Colorectal cancer CRC and colon
More informationV most often occur in the rectum and sigmoid
VILLOUS ADENOMAS OF THE RIGHT COLON WALTER B. GOLDFARR, M.D. ILLOUS ADENOMAS ARE NEOPLASMS THAT V most often occur in the rectum and sigmoid colon.7.8,21 These tumors exhibit a high propensity for malignant
More informationSurveying the Colon; Polyps and Advances in Polypectomy
Surveying the Colon; Polyps and Advances in Polypectomy Educational Objectives Identify classifications of polyps Describe several types of polyps Verbalize rationale for polypectomy Identify risk factors
More information8. The polyp in the illustration can be described as (circle all that apply) a. Exophytic b. Pedunculated c. Sessile d. Frank
Quiz 1 Overview 1. Beginning with the cecum, which is the correct sequence of colon subsites? a. Cecum, ascending, splenic flexure, transverse, hepatic flexure, descending, sigmoid. b. Cecum, ascending,
More informationCommonly Encountered Neuro-Endocrine Tumors of the Gut
Commonly Encountered Neuro-Endocrine Tumors of the Gut Moderators: Giuseppe Aliperti, MD Steven Edmundowicz, MD Panelists Douglas O. Faigel, MD Professor of Medicine Department of Gastroenterology Oregon
More informationFamilial Juvenile Polyposis Coli
GASTROENTEROLOGY 982 ;82 :494-50 Familial Juvenile Polyposis Coli A Clinical and Pathologic Study of a Large Kindred HAROLD W. GROTSKY, ROBERT R. RICKERT, WILLARD D. SMITH, and JAMES F. NEWSOME The Departments
More informationSection of Proctology
13 Voluime 67June 1974 451 Section of Proctology President Basil Morson MD Meeting 5 December 1973 President's Address The Polyp-cancer Sequence in the Large Bowel by Basil Morson MD (St Mark's Hospital,
More informationPapillary Lesions of the Breast: WHO Update
Papillary Lesions of the Breast: WHO Update Stuart J. Schnitt, M.D. Department of Pathology Beth Israel Deaconess Medical Center and Harvard Medical School Boston, MA, USA Papillary Lesions of the Breast
More information[GANN, 65, ; August, 1974] ADENOMATOUS POLYPS OF LARGE INTESTINE IN AUTOPSY AND SURGICAL MATERIALS
[GANN, 65, 295-306; August, 1974] ADENOMATOUS POLYPS OF LARGE INTESTINE IN AUTOPSY AND SURGICAL MATERIAL*1 Eiichi SATO Department of Pathology, Tohoku University School of Medicine*2 A study of the large
More informationColon Polyp Morphology on Double-Contrast Barium Enema: Its Pathologic Predictive Value
965 David J. Ott 1 David W. Gelfand 1 Wallace C. Wu 2 Deborah S. Ablin 1-3 Received March 21, 1983; accepted after revision July 8, 1983. 'Department of Radiology, Bowman Gray School of Medicine, Winston-Salem,
More informationColonic adenomas-a colonoscopy survey
Gut, 1979, 20, 240-245 Colonic adenomas-a colonoscopy survey P. E. GILLESPIE, T. J. CHAMBERS, K. W. CHAN, F. DORONZO, B. C. MORSON, AND C. B. WILLIAMS From St Mark's Hospital, City Road, London SUMMARY
More informationAlberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines
Alberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines June 2013 ACRCSP Post Polypectomy Surveillance Guidelines - 2 TABLE OF CONTENTS Background... 3 Terms, Definitions
More informationWendy L Frankel. Chair and Distinguished Professor
1 Wendy L Frankel Chair and Distinguished Professor Case 1 59 y/o woman Abdominal pain No personal or family history of cancer History of colon polyps Colonoscopy Polypoid rectosigmoid mass Biopsy 3 4
More informationEpithelial tumors. Dr. F.F. Khuzin, PhD Dr. M.O. Mavlikeev
Epithelial tumors Dr. F.F. Khuzin, PhD Dr. M.O. Mavlikeev Epithelial tumors Tumors from the epithelium are the most frequent among tumors. There are 2 group features of these tumors: The presence in most
More informationPrimary mucinous adenocarcinoma developing in an ileostomy stoma
Gut, 1988, 29, 1607-1612 Primary mucinous adenocarcinoma developing in an ileostomy stoma P J SMART, S SASTRY, AND S WELLS From the Departments of Histopathology and Surgery, Bolton General Hospital, Fan
More informationT colonoscopy (Fig. 1) which permits direct
FLEXIBLE COLONOSCOPY HIROMI SHINYA, MD,* AND WILLIAM WOLFF, MD~ Colonoscopy with fiberoptic instruments has opened new vistas in diagnosis and treatment of colonic disease. Such endoscopy requires skill,
More informationHistopathological analysis of benign polyps in patients with carcinoma of the colon and rectum
Gut, 1974, 15, 654-663 Histopathological analysis of benign polyps in patients with carcinoma of the colon and rectum G. EKELUND AND C. LINDSTROM From the Departments of Surgery and Pathology, University
More informationStructured Follow-Up after Colorectal Cancer Resection: Overrated. R. Taylor Ripley University of Colorado Grand Rounds April 23, 2007
Structured Follow-Up after Colorectal Cancer Resection: Overrated R. Taylor Ripley University of Colorado Grand Rounds April 23, 2007 Guidelines for Colonoscopy Production: Surveillance US Multi-Society
More informationPSA. HMCK, p63, Racemase. HMCK, p63, Racemase
Case 1 67 year old male presented with gross hematuria H/o acute prostatitis & BPH Urethroscopy: small, polypoid growth with a broad base emanating from the left side of the verumontanum Serum PSA :7 ng/ml
More informationAuthor(s) Miura, Toshio; Tomita, Masao; Kawag. Citation Acta medica Nagasakiensia. 1994, 39
NAOSITE: Nagasaki University's Ac Title Author(s) Vascular Patterns of Villous Tumors Shimoyama, Takatoshi; Shimizu, Teru Atsushi; Uchikawa, Tetsuya; Matsuo, Hisano, Hiroshi; Kida, Harumi; Yosh Miura,
More informationMammary Nodular Hyperplasia in Intact R hesus Monkeys
Vet. Path. 10: 130-134 (1973) Mammary Nodular Hyperplasia in Intact R hesus Monkeys L. W NELSON and L. D. SHOTT Department of Pathology and Toxicology, Mead Johnson Research Center, Evansville, Ind., and
More informationThe 2015 World Health Organization Classification for Lung Adenocarcinomas: A Practical Approach
The 2015 World Health Organization Classification for Lung Adenocarcinomas: A Practical Approach Dr. Carol Farver Director, Pulmonary Pathology Pathology and Laboratory Medicine Institute Objectives Discuss
More informationCOLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE
COLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE PROFESSOR OF SURGERY & DIRECTOR, PROFESSIONAL DEVELOPMENT CENTRE J I N N A H S I N D H M E D I C A L U N I V E R S I T Y faisal.siddiqui@jsmu.edu.pk
More informationPapillary Lesions of the Breast A Practical Approach to Diagnosis. (Arch Pathol Lab Med. 2016;140: ; doi: /arpa.
Papillary Lesions of the Breast A Practical Approach to Diagnosis (Arch Pathol Lab Med. 2016;140:1052 1059; doi: 10.5858/arpa.2016-0219-RA) Papillary lesions of the breast Span the spectrum of benign,
More informationPolypectomy and Local Resections of the Colorectum Structured Pathology Reporting Proforma
Polypectomy and Local Resections of the Colorectum Structured Pathology Reporting Proforma Mandatory questions (i.e. protocol standards) are in bold (e.g. S1.03). Family name Given name(s) Date of birth
More informationremoval of adenomatous polyps detects important effectively as follow-up colonoscopy after both constitute a low-risk Patients with 1 or 2
Supplementary Table 1. Study Characteristics Author, yr Design Winawer et al., 6 1993 National Polyp Study Jorgensen et al., 9 1995 Funen Adenoma Follow-up Study USA Multi-center, RCT for timing of surveillance
More informationmalignant polyp Daily Challenges in Digestive Endoscopy for Endoscopists and Endoscopy Nurses BSGIE Annual Meeting 18/09/2014 Mechelen
Plan Incidental finding of a malignant polyp 1. What is a polyp malignant? 2. Role of the pathologist and the endoscopist 3. Quantitative and qualitative risk assessment 4. How to decide what to do? Hubert
More informationMorphologic Criteria of Invasive Colonic Adenocarcinoma on Biopsy Specimens
ISPUB.COM The Internet Journal of Pathology Volume 12 Number 1 Morphologic Criteria of Invasive Colonic Adenocarcinoma on Biopsy Specimens C Rose, H Wu Citation C Rose, H Wu.. The Internet Journal of Pathology.
More informationReferences. GI Biopsies. What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD
What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD jcrawford1@nshs.edu Executive Director and Senior Vice President for Laboratory Services North
More informationNeoplasia part I. Dr. Mohsen Dashti. Clinical Medicine & Pathology nd Lecture
Neoplasia part I By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 2 nd Lecture Lecture outline Review of structure & function. Basic definitions. Classification of neoplasms. Morphologic features.
More informationQuality of and compliance with colonoscopy in Lynch Syndrome surveillance: are we getting it right?
Quality of and compliance with colonoscopy in Lynch Syndrome surveillance: are we getting it right? Hartery K 1, Sukha A 1, Thomas-Gibson S 1, Thomas H 1,2, Latchford A 1,2. 1 Wolfson Endoscopy Unit, St.
More informationSessile Serrated Polyps
Årsmøtet i Den norske Patologforening 2014 Sessile Serrated Polyps Tor J. Eide Oslo Universitetssykehus The term serrated include a group of lesions with a sawtoothlike appearance of the crypts and the
More informationIn-situ and invasive carcinoma of the colon in patients with ulcerative colitis
Gut, 1972, 13, 566-570 In-situ and invasive carcinoma of the colon in patients with ulcerative colitis D. J. EVANS AND D. J. POLLOCK From the Departments of Pathology, Royal Postgraduate Medical School
More informationLuminal Histological Outline and Colonic Adenoma Phenotypes
Luminal Histological Outline and Colonic Adenoma Phenotypes CARLOS A. RUBIO Gastrointestinal and Liver Pathology Research Laboratory, Department of Pathology, Karolinska Institute and University Hospital,
More informationNeoplastic Colon Polyps. Joyce Au SUNY Downstate Grand Rounds, October 18, 2012
Neoplastic Colon Polyps Joyce Au SUNY Downstate Grand Rounds, October 18, 2012 CASE 55M with Hepatitis C, COPD (FEV1=45%), s/p vasectomy, knee surgery Meds: albuterol, flunisolide, mometasone, tiotropium
More informationCase: The patient is a 24 year- old female who was found to have multiple mural nodules within the antrum. Solid and cystic components were noted on
Case: The patient is a 24 year- old female who was found to have multiple mural nodules within the antrum. Solid and cystic components were noted on imaging. There is no significant past medical history.
More informationModern colonoscopy allows for both diagnosis and treatment
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2007;5:662 667 CLINICAL PATHOLOGY The Malignant Colon Polyp: Diagnosis and Therapeutic Recommendations MARIE E. ROBERT Department of Pathology, Yale University
More informationPapillary Lesions of the Breast
Papillary Lesions of the Breast Laura C. Collins, M.D. Associate Professor of Pathology Associate Director, Division of Anatomic Pathology Beth Israel Deaconess Medical Center and Harvard Medical School
More informationBasaloid carcinoma of the anal canal
J. clin. Path. (1967), 0, 18 Basaloid carcinoma of the anal canal LILLIAN S. C. PANG AND B. C. MORSON From the Research Department, St. Mark's Hospital, London SYNOPSIS The pathology and results of treatment
More informationSurgical Management of Neuroendocrine Tumors of the Gut. Richard Hodin MD Professor of Surgery Massachusetts General Hospital Harvard Medical School
Surgical Management of Neuroendocrine Tumors of the Gut Richard Hodin MD Professor of Surgery Massachusetts General Hospital Harvard Medical School Sites of GI Carcinoid Tumors Small intestine 44% Rectum
More informationColorectal adenocarcinoma leading cancer in developed countries In US, annual deaths due to colorectal adenocarcinoma 57,000.
Colonic Neoplasia Remotti Colorectal adenocarcinoma leading cancer in developed countries In US, annual incidence of colorectal adenocarcinoma 150,000. In US, annual deaths due to colorectal adenocarcinoma
More information2007 Multiple Primary and
2007 Multiple Primary and Histology Coding Rules Beyond the Basics Florida Cancer Data System Annual Conference Tampa, FL July 26,2007 Steven Peace, CTR Westat Carol Johnson, CTR NCI SEER Peggy Adamo,
More information11/21/13 CEA: 1.7 WNL
Case Scenario 1 A 70 year-old white male presented to his primary care physician with a recent history of rectal bleeding. He was referred for imaging and a colonoscopy and was found to have adenocarcinoma.
More informationand intussusception the caecum was made.
Postgraduate Medical Journal (October 1974) 5, 65-654. Villous papilloma of the appendix associated with mucocoele and intussusception A. J. DARBY M.B., B.S., M.R.C.Path. A. DOCTOR M.S., F.R.C.S. Departments
More informationMalignancy in ulcerative colitis (UC) is believed to ORIGINAL ARTICLES
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2004;2:534 541 ORIGINAL ARTICLES Long-term Follow-up After Polypectomy Treatment for Adenoma-Like Dysplastic Lesions in Ulcerative Colitis ROBERT D. ODZE,* FRANCIS
More informationTitle: Concurrence of villous adenoma and non-muscle invasive bladder cancer arising in the bladder: a case report
Author's response to reviews Title: Concurrence of villous adenoma and non-muscle invasive bladder cancer arising in the bladder: a case report Authors: Yoichiro Kato (j2c789@bma.biglobe.ne.jp) Susumu
More informationSelect problems in cystic pancreatic lesions
Disclosure Select problems in cystic pancreatic lesions Five Prime Therapeutics shareholder Adicet Bio shareholder Bristol-Meyer Squibb advisory board grace.kim@ucsf.edu Pancreatic cystic lesions Intraductal
More informationOPEN ACCESS TEXTBOOK OF GENERAL SURGERY
OPEN ACCESS TEXTBOOK OF GENERAL SURGERY COLORECTAL POLYPS P Goldberg POLYP A polyp is a localised elevated lesion arising from a epithelial surface. If it has a stalk it is called a pedunculated polyp
More informationCHAPTER 7 Concluding remarks and implications for further research
CONCLUDING REMARKS AND IMPLICATIONS FOR FURTHER RESEARCH CHAPTER 7 Concluding remarks and implications for further research 111 CHAPTER 7 Molecular staging of large sessile rectal tumors In this thesis,
More informationGross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of
Tiền liệt tuyến Tiền liệt tuyến Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of solid and microcystic areas.
More information2018 SEER Solid Tumor Manual 2018 KCR SPRING TRAINING
2018 SEER Solid Tumor Manual 2018 KCR SPRING TRAINING Eight Groups are Revised for 2018 Head & Neck Colon (includes rectosigmoid and rectum for cases diagnosed 1/1/2018 forward) Lung (2018 Draft not yet
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Colorectal cancer: colonoscopic surveillance for prevention of colorectal cancer in patients with ulcerative colitis, Crohn
More informationPage 1. Is the Risk This High? Dysplasia in the IBD Patient. Dysplasia in the Non IBD Patient. Increased Risk of CRC in Ulcerative Colitis
Screening for Colorectal Neoplasia in Inflammatory Bowel Disease Francis A. Farraye MD, MSc Clinical Director, Section of Gastroenterology Co-Director, Center for Digestive Disorders Boston Medical Center
More informationencapsulated thyroid nodule with a follicular architecture and some form of atypia. The problem is when to diagnose
Histological Spectrum of Papillary Carcinoma of Thyroid A Two Years Study Gomathi Srinivasan 1, M. Vennila 2 1 Associate Professor Pathology, Government Medical College, Omandurar Estate, Chennai 600 002
More informationA superficial radiotherapy B single pass curettage C excision with 2 mm margins D excision with 5 mm margins E Mohs micrographic surgery.
1- A 63-year-old woman presents with a non-healing lesion on her right temple that has been present for over two years. On examination there is a 6 mm well defined lesion with central ulceration, telangiectasia
More informationLarge polyps: EMR, ESD, TEM and segmental resection. Terry Phang 2017 SON fall update
Large polyps: EMR, ESD, TEM and segmental resection Terry Phang 2017 SON fall update Key Points: Large polyps No RCT re: Recurrence, complications Piecemeal vs en bloc: EMR vs ESD Partial vs full-thickness:
More informationDisclosure. Case. Mixed Tumors of the Uterine Corpus and Cervix. I have nothing to disclose
Mixed Tumors of the Uterine Corpus and Cervix Marisa R. Nucci, M.D. Division of Women s and Perinatal Pathology Department of Pathology Brigham and Women s Hospital Boston, MA UCSF Current Issues in Anatomic
More informationCASE REPORTS. Inflammatory Polyp of the Bronchus. V. K. Saini, M.S., and P. L. Wahi, M.D.
CASE REPORTS V. K. Saini, M.S., and P. L. Wahi, M.D. I n 1932 Jackson and Jackson [l] first reported a number of clinical cases under the title Benign Tumors of the Trachea and Bronchi with Especial Reference
More informationEmerging Interventions in Endoscopy. Margaret Vance Nurse Consultant in Gastroenterology St Mark s Hospital
Emerging Interventions in Endoscopy Margaret Vance Nurse Consultant in Gastroenterology St Mark s Hospital Colon Cancer Colon cancer is common. 1 in 20 people in the UK will develop the disease 19 000
More informationMalignant colorectal polyps: venous invasion and
774 Gut, 1991,32, 774-778 Malignant colorectal polyps: venous invasion and successful treatment by endoscopic polypectomy Department of Pathology J M Geraghty Endoscopy Unit C B Williams and ICRF Colorectal
More informationColon Screening in 2014 Offering Patients a Choice. Clark A Harrison MD The Nevada Colon Cancer Partnership
Colon Screening in 2014 Offering Patients a Choice Clark A Harrison MD The Nevada Colon Cancer Partnership Objectives 1. Understand the incidence and mortality rates for CRC in the US. 2. Understand risk
More informationVULVAR CARCINOMA. Page 1 of 5
VULVAR CARCINOMA EXAMPLE OF A VULVAR CARCINOMA USING PROPOSED TEMPLATE Case: Invasive squamous cell carcinoma arising in D-VIN Tumor in left labia major Left partial vaginectomy and sentinel lymph node
More informationCT Colonography: Image interpretation. Beth G. McFarland, MD
CT Colonography: Image interpretation Beth G. McFarland, MD Part III CTC Overview of different morphologic types:» Focal polyp vs stool» Sessile lesion and flat lesions» Pedunculated lesion» Cancer vs
More informationCOLORECTAL SCREENING PROGRAMME: IMPACT ON THE HOSPITAL S PATHOLOGY SERVICES SINCE ITS INTRODUCTION.
The West London Medical Journal 2009 Vol No 1 pp 23-31 COLORECTAL SCREENING PROGRAMME: IMPACT ON THE HOSPITAL S PATHOLOGY SERVICES SINCE ITS INTRODUCTION. Competing interests: None declared ABSTRACT Sarah
More informationUpdate on Thyroid FNA The Bethesda System. Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center
Update on Thyroid FNA The Bethesda System Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center Thyroid Nodules Frequent occurrence Palpable: 4-7% of adults Ultrasound: 10-31% Majority benign
More informationCarcinoembryonic Antigen Immunoreactivity Patterns in Colorectal Cancer: Correlation with Morphologic Parameters
Carcinoembryonic Antigen Immunoreactivity Patterns in Colorectal Cancer: Correlation with Morphologic Parameters Simun Andelinovic, MD; Jerolim Bakotin, MD; Zeljko Dujic, MD; Deny Andelinovic, MD; Robert
More informationIncidence and Multiplicities of Adenomatous Polyps in TNM Stage I Colorectal Cancer in Korea
Original Article Journal of the Korean Society of J Korean Soc Coloproctol 2012;28(4):213-218 http://dx.doi.org/10.3393/jksc.2012.28.4.213 pissn 2093-7822 eissn 2093-7830 Incidence and Multiplicities of
More informationRomanian Journal of Morphology and Embryology 2006, 47(3):
Romanian Journal of Morphology and Embryology 26, 7(3):239 23 ORIGINAL PAPER Predictive parameters for advanced neoplastic adenomas and colorectal cancer in patients with colonic polyps a study in a tertiary
More informationStromal Fat Content of the Parathyroid Gland
Stromal Fat Content of the Parathyroid Gland TAKAO OBARA,* YOSHIHIDE FUJIMOTO* AND MOTOHIKO AIBA** *Department of Endocrine Surgery and **Department of Surgical Pathology, Tokyo Women's Medical College,
More informationSmall Intestine. Protocol revision date: January 2005 Based on AJCC/UICC TNM, 6 th edition
Small Intestine Protocol applies to all invasive carcinomas of the small intestine, including those with focal endocrine differentiation. Excludes carcinoid tumors, lymphomas, and stromal tumors (sarcomas).
More informationPreface to the Second Edition
Preface to the Second Edition This second edition of Diagnosis of Endometrial Biopsies and Curettings: A Practical Approach follows a number of favorable comments we received about the first edition. As
More informationSerotonin- and Somatostatin-Positive Goblet Cell Carcinoid of the Duodenum
2012 66 4 351 356 Serotonin- and Somatostatin-Positive Goblet Cell Carcinoid of the Duodenum a b* c c c a a b d a c b d 352 Ohara et al. received remedies at another hospital. Hematemesis then recurred
More informationPresentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98
Presentation material is for education purposes only. All rights reserved. 2011 URMC Radiology Page 1 of 98 Radiology / Pathology Conference February 2011 Brooke Koltz, Cytopathology Resident Presentation
More informationSaudi Journal of Pathology and Microbiology (SJPM)
Saudi Journal of Pathology and Microbiology (SJPM) Scholars Middle East Publishers Dubai, United Arab Emirates Website: http://scholarsmepub.com/ ISSN 2518-3362 (Print) ISSN 2518-3370 (Online) Histopathological
More informationPROTOCOL SENTINEL NODE BIOPSY (NON OPERATIVE) BREAST CANCER - PATHOLOGY ASSESSMENT
PROTOCOL SENTINEL NODE BIOPSY (NON OPERATIVE) BREAST CANCER - PATHOLOGY ASSESSMENT Author: Dr Sally Ann Hales On behalf of the Breast and pathology CNGs Written: March 2005 Reviewed by CNG: June 2009 &
More informationDisorders of Cell Growth & Neoplasia. Histopathology Lab
Disorders of Cell Growth & Neoplasia Histopathology Lab Paul Hanna April 2010 Case #84 Clinical History: 5 yr-old, West Highland White terrier. skin mass from axillary region. has been present for the
More informationThe Use of Pancreatoscopy in the Diagnosis of Intraductal Papillary Mucinous Tumor Lesions of the Pancreas
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2005;3:S53 S57 The Use of Pancreatoscopy in the Diagnosis of Intraductal Papillary Mucinous Tumor Lesions of the Pancreas KENJIRO YASUDA, MUNEHIRO SAKATA, MOOSE
More informationCase history: Figure 1. H&E, 5x. Figure 2. H&E, 20x.
1 Case history: A 49 year-old female presented with a 5 year history of chronic anal fissure. The patient s past medical history is otherwise unremarkable. On digital rectal examination there was a very
More informationScreening & Surveillance Guidelines
Chapter 2 Screening & Surveillance Guidelines I. Eligibility Coloradans ages 50 and older (average risk) or under 50 at elevated risk for colon cancer (personal or family history) that meet the following
More informationGUIDELINES ON NON-MUSCLE- INVASIVE BLADDER CANCER
GUIDELINES ON NON-MUSCLE- INVASIVE BLADDER CANCER (Limited text update December 21) M. Babjuk, W. Oosterlinck, R. Sylvester, E. Kaasinen, A. Böhle, J. Palou, M. Rouprêt Eur Urol 211 Apr;59(4):584-94 Introduction
More informationESD for EGC with undifferentiated histology
ESD for EGC with undifferentiated histology Jun Haeng Lee, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Biopsy: M/D adenocarcinoma ESD: SRC >>
More informationTHE CLASSIFICATION OF BLADDER TUMOURS
41 THE CLASSIFICATION OF BLADDER TUMOURS T. J. DEELEY AND V. J. DESMET* From the Radiotherapy Department, Hammersmith Hospital, Du Cane Road, London, IF7.12, and the Department of Pathology, Louvain University,
More information