The significance of ectopic crypt formation in the differential diagnosis of colorectal polyps

Diagnostic Pathology

Eui Gon Youk³  Doo Han Lee³  Do Sun Kim³  Se-Jin Jang²  Sung-Min Chun²  Eun-Jung Lee³  Mi-Jung Kim¹ 

[1] Department of Pathology, Daehang hospital, 481-10 BangBae3-dong, Seoul 137-820, Seocho-gu, Republic of Korea;Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Poongnap 2-Dong, Seoul 138-736, Songpa-Gu, Republic of Korea;Department of Surgery, Daehang hospital, Seoul, Republic of Korea

关键词: KRAS;    BRAF;    Ectopic crypt formation;    Colon;    Conventional adenoma;    Traditional serrated adenoma;   

Others  :  1149341
DOI  :  10.1186/s13000-014-0212-x

 received in 2014-06-30, accepted in 2014-10-26,  发布年份 2014

【 摘 要 】

Background

Ectopic crypts, defined as abnormally positioned crypts that have lost their orientation toward the muscularis mucosae, have been suggested to be the best defining histologic feature of traditional serrated adenoma (TSA). However, the significance of ectopic crypt formation (ECF) in the distinction between TSA and conventional adenoma (CA) has rarely been studied.

Methods

We designed this study to determine if ECF can be found in CA and its presence is exclusive to TSA. We studied 107 TSAs and 191 CAs including 106 tubular adenomas (TAs), 66 tubulovillous adenomas (TVAs), and 19 villous adenomas (VAs).

Results

ECF was identified in most (79.4%) but not all TSAs. Additionally, ECF was not infrequent in CA (62 of 191, 32.5%), and its presence correlated with the presence of a villous component and larger tumor size (each p <0.001).

Conclusions

Based on its strong association with the presence of a villous component and larger tumor size, ECF appears to be involved in the protuberant growth of colorectal CA. Because ECF can be found in CA, particularly in cases with a villous component, the possibility of CA should be considered before making a diagnosis of TSA when encountering colorectal polyps with ECF.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_212 webcite

【 授权许可】

   
2014 Kim et al.; licensee BioMed Central Ltd.

【 图 表 】

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