Colonic tubular adenoma with incidental oxyntic gastric heterotopia

Abstract Background Sessile colorectal lesions which do not elevate with submucosal injection — “non-lifting” lesions — are considered poor candidates for EMR due to concerns of possible invasive cancer and increased procedural risk. However, a non-lifting sign is an unreliable predictor of malignancy, relegating many benign lesions to surgical resection. Underwater EMR (UEMR), which obviates submucosal injection, is effective for sessile colorectal polyps but has not been evaluated specifically for non-lifting lesions. Aims The aim of this study was to assess the efficacy of UEMR for “non-lifting” large sessile colorectal lesions with the hypothesis that UEMR may have a clinical role in managing complex lesions. Methods We reviewed our database from 2016 to 2019 for patients referred for large (≥ 20 mm) non-lifting colorectal lesions without overt signs of invasive cancer, who subsequently underwent UEMR. Results Thirty-two cases were successfully treated with single session UEMR. 18 (56%) were de novo lesions whereas the remainder had undergone previous attempt(s) at conventional EMR. The mean lesion size was 37 ± 17 mm. 4 cases (13%) were resected en bloc; the remainder piecemeal. Final pathology was T1 adenocarcinoma, N=3 (9%); tubulovillous adenoma, N=15 (47%); tubular adenoma, N=8 (25%); sessile serrated, N=6 (19%); high-grade dysplasia, N=2 (6%). One patient with cancer underwent surgical resection (T1N0); the remainder had endoscopic follow-up over 8 ± 3 months with benign recurrent/residual lesions in 8%, all amenable to UEMR. There were no procedural complications. Conclusions In this series of large sessile non-lifting colorectal lesions, UEMR was effective for both de novo and previously treated lesions, obviating surgery in the majority of cases. Funding Agencies None

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The many faces of intestinal tract gastric heterotopia; a series of four cases highlighting clinical and pathological heterogeneity

Human Pathology ◽

10.1016/j.humpath.2018.01.003 ◽

2018 ◽

Vol 74 ◽

pp. 183-187 ◽

Cited By ~ 1

Author(s):

Aqsa Nasir ◽

Stuart K. Amateau ◽

Sabina Khan ◽

Ross W. Simpson ◽

Dale C. Snover ◽

...

Keyword(s):

Intestinal Tract ◽

Gastric Heterotopia ◽

The Many

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Polypoid Gastric Heterotopia in the Gallbladder

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/00005176-199407000-00025 ◽

1994 ◽

Vol 19 (1) ◽

pp. 129-131 ◽

Cited By ~ 17

Author(s):

G. Schimpl ◽

G. Schaffler ◽

E. Sorantin ◽

M. Ratschek ◽

M. Klimpfinger

Keyword(s):

Gastric Heterotopia

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Adenomatous Polyps in Adolescent Girl and Boy: A Report of Two Cases

Case Reports in Pathology ◽

10.1155/2016/8256745 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Laleh Vahedi Larijani ◽

Maryam Ghasemi ◽

Hassan Karami

Keyword(s):

Pediatric Patients ◽

Colonic Polyps ◽

Definitive Diagnosis ◽

Adenomatous Polyps ◽

Common Symptom ◽

Tubular Adenoma ◽

Tubulovillous Adenoma ◽

Benign Adenoma ◽

Juvenile Type ◽

Rectal Hemorrhage

A polyp is defined as a mass of the mucosal surface that protrudes into the lumen of the gastrointestinal tract. Neoplastic epithelial polyps are classified histologically as either benign adenoma or malignant carcinoma. The colonic polyps that most commonly present in children occur sporadically and individually and are of the juvenile type; they are most frequently associated with painless rectal hemorrhage (which is the most common symptom). Adenomatous polyps are similar to other nontumoral polyps, and it is very rare for children to have symptoms other than rectal bleeding. This report describes two rare cases of polyps in pediatric patients. An 11-year-old girl presented with tubulovillous adenoma and a 13-year-old boy with tubular adenoma; both patients complained of rectal hemorrhage as well as anemia and abdominal pain. Epithelial adenoma is a tumor that is rarely found in adults or children. Colonoscopic perforation and biopsy are mandatory for establishing a definitive diagnosis and avoiding medical mismanagement.

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TUBULAR ADENOMA WITH FOCAL SQUAMOUS METAPLASIA OF THE ASCENDING COLON

Pathology International ◽

10.1111/j.1440-1827.1985.tb00593.x ◽

1985 ◽

Vol 35 (2) ◽

pp. 507-515

Author(s):

Itsuro Hayashi ◽

Yasaburo Katsuda ◽

Minoru Morimatsu ◽

Yuuji Miyamoto ◽

Hideyasu Kiyonaei ◽

...

Keyword(s):

Squamous Metaplasia ◽

Tubular Adenoma ◽

Ascending Colon

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HISTOPATHOLOGICALANALYSIS OF TUMOURS AND TUMOUR-LIKE LESIONS OF COLON AND RECTUM

10.36106/ijsr/2538967 ◽

2021 ◽

pp. 9-11

Author(s):

Durga Nand Jha ◽

Hari Shankar Mishra ◽

Ajit Kumar Chaudhary ◽

Debarshi Jana

Keyword(s):

Histopathological Examination ◽

Correct Diagnosis ◽

Malignant Tumour ◽

Juvenile Polyp ◽

Tubular Adenoma ◽

Malignant Tumours ◽

Cross Sectional ◽

Colorectal Biopsies ◽

Colon And Rectum ◽

Benign Tumours

Background:Tumours and tumour like lesions of the colon and rectum have overlapping clinical presentation and may be difcult to diagnose on clinical grounds alone. Histopathological examination although helpful to arrive at correct diagnosis, at times may be difcult and may require ancillary tests such as immunohistochemistry. Materials and Methods: A prospective cross sectional study enrolled 125 cases of colorectal biopsies after histopathological conrmation of tumours and tumour like lesions. The specimens were received at the Department of Pathology, DMCH, Laheriasarai, Bihar from December 2019 to November 2020. Results: Out of 125 cases, 32 cases were benign tumours, 36 cases were malignant tumours and 57 cases were tumour like lesions. Most common age range was 51-60 years with mean age of 38 years. Males comprised 76.74% and females 23.26% with ratio of 3:1. Juvenile polyp was the commonest lesion. Among benign tumours, tubular adenoma was the most common (19.2%), adenocarcinoma was most common malignant tumour (25.6%) and juvenile polyp was the most common tumour like lesion (27.2%). Left side was most common side (66.67%) and rectum was the most common site (48.8%). Conclusions: The commonest indications for colorectal biopsies were tumours and tumour like lesions. Juvenile polyp was the most common tumour like lesion, tubular adenoma was the most common benign tumour and adenocarcinoma was the most common malignant tumour. Histopathological examination is a gold standard for conrmation of all tumour and tumours like lesions of colon and rectum.

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Focal Intramucosal Adenocarcinoma Occurring in Gastric Hyperplastic Polyps Treated with Endoscopic Mucosal Resection

Case Reports in Gastrointestinal Medicine ◽

10.1155/2018/7431290 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Jéssica Alférez-Andía ◽

Harold Benites-Goñi ◽

Fernando Palacios-Salas

Keyword(s):

Hyperplastic Polyp ◽

Magnifying Endoscopy ◽

Gastric Body ◽

Tubular Adenocarcinoma ◽

Tubular Adenoma ◽

High Grade ◽

Hyperplastic Polyps ◽

Color Enhancement ◽

Intramucosal Adenocarcinoma ◽

Well Differentiated

Hyperplastic polyps are the most frequent benign epithelial gastric polyps. Although they are considered nonneoplastic, some cases have been reported with focal adenocarcinoma. We present the case of a 59-year-old woman with a sessile lesion of 15 mm on the distal gastric body associated with an extensive atrophic gastritis. Magnifying endoscopy with Fuji Intelligent Color Enhancement (FICE) revealed an irregular microsurface pattern at the apex, suggesting malignancy. A mucosectomy was performed. The histopathology revealed that the base corresponded to a hyperplastic polyp, where a tubular adenoma with high-grade dysplasia was established, with focal well-differentiated intramucosal tubular adenocarcinoma.

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