Further studies on serrated neoplasias of the cardia: a review and case report.

We have previously recorded 6 cases of serrated adenoma in the cardia. Here we report a case, which differed cytologically from the 6 preceding cases in as much as the adenomatous cells had clear, micro-vacuolated cytoplasm and secreted neutral mucins. Similar cellular features found in gastric carcinomas were classified by Mulligan as of pylorocardiac gland cell type. Six of the 7 cases (including the one reported here) showed areas of invasive carcinoma. Because of its location, histological and histochemical features, the reported neoplasia was called serrated adenoma malignum of the cardia (Mulligan type). Serrated adenomas of the cardia seem to have a particular proclivity to evolve into invasive carcinomas.