Roessner A, Kuester D, Guenther T
Institut für Pathologie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
Pathologe. 2011 Jul;32(4):303-13. doi: 10.1007/s00292-011-1437-z.
Biopsies and resection specimens of the gastrointestinal tract are a major part of the routine workload in many histopathology departments, whereby polypoid lesions are generally the main focus. In addition to distinguishing non-neoplastic from neoplastic polyps and evaluating the grade of dysplasia of the latter, the pathologist should always consider the possibility of an underlying polyposis syndrome. Not only have additional hereditary polyposis syndromes been identified in recent years due to a better understanding of their genetic and epigenetic alterations but also knowledge on well known polyposes has improved, leading to subtyping of various forms according to their different genotype. It is essential for the histopathologist to understand that the conventional histomorphology of individual polyps combined with information on the number and distribution of these lesions and clinical data can provide clues regarding a possible hereditary background. Therefore, the correct histological assessment of polyps is not just about getting the diagnosis right, it might also lead to genetic screening of family members and spouses.
胃肠道活检和切除标本是许多组织病理学科室日常工作量的主要部分,其中息肉样病变通常是主要关注点。除了区分非肿瘤性息肉和肿瘤性息肉并评估后者的发育异常程度外,病理学家还应始终考虑潜在息肉病综合征的可能性。近年来,由于对遗传和表观遗传改变有了更好的理解,不仅发现了更多的遗传性息肉病综合征,而且对知名息肉病的认识也有所提高,从而根据不同的基因型对各种形式进行了亚型分类。组织病理学家必须明白,单个息肉的传统组织形态学特征,结合这些病变的数量、分布信息以及临床数据,可以为可能的遗传背景提供线索。因此,对息肉进行正确的组织学评估不仅关乎正确诊断,还可能导致对家庭成员和配偶进行基因筛查。