Lee Eun-Jung, Kim Mi-Jung, Chun Sung-Min, Jang Se-Jin, Kim Do Sun, Lee Doo Han, Youk Eui Gon
Department of Surgery, Daehang Hospital, Seoul, Republic of Korea.
Department of Pathology, Daehang Hospital, 481-10 BangBae3-dong, Seocho-gu, 137-820, Seoul, Republic of Korea.
Diagn Pathol. 2015 Jun 20;10:75. doi: 10.1186/s13000-015-0325-x.
Sessile serrated adenoma/polyps (SSA/Ps) usually appear flat to sessile with a smooth-appearing surface. However, macroscopic appearances of SSA/P can vary from flat-elevated to nodular and can even show a pedunculated configuration as we previously reported. The aim of the current study was to evaluate the clinicopathologic features of another under-recognized form of SSA/P which shows a depressed surface. Among 634 cases of sessile serrated adenoma/polyp, a total of seven sessile serrated adenoma/polyps showing a depressed surface were identified in 6 patients during the review of endoscopic images between January 2013 and November 2013. One of these was found during the review of previous endoscopic images of the same patient. Patients were more often middle-aged to elderly men (83.3%) and had synchronous conventional adenomas and/or SSA/Ps except for one man. The polyps usually occurred in the proximal colon (71.4%) and the mean size of polyps was 9.3 mm (range; 6-13 mm). Most cases (71.4%) were of a flat-elevated type, and the remaining polyps (28.6%) were sessile. The majority of polyps (85.7%) showed a mucus cap. All but one of the cases (85.7%) showed BRAF-V600E mutations. Our findings are that SSA/Ps can show a central depression although such cases are rare. The endoscopic and clinicopathologic features of SSA/Ps showing a depressed surface appear to be similar to usual SSA/Ps except for the presence of a depressed surface and marked male preponderance. Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1562070886167874 .
无蒂锯齿状腺瘤/息肉（SSA/Ps）通常表现为扁平至无蒂，表面光滑。然而，如我们之前所报道，SSA/P的宏观表现可从扁平隆起至结节状，甚至可呈有蒂形态。本研究的目的是评估另一种未被充分认识的呈凹陷表面的SSA/P的临床病理特征。在634例无蒂锯齿状腺瘤/息肉病例中，2013年1月至2013年11月期间在内镜图像复查中，6例患者共发现7例呈凹陷表面的无蒂锯齿状腺瘤/息肉。其中1例是在复查同一患者之前的内镜图像时发现的。患者多为中老年男性（83.3%），除1名男性外，均有同步的传统腺瘤和/或SSA/Ps。息肉通常发生在近端结肠（71.4%），息肉平均大小为9.3毫米（范围：6 - 13毫米）。大多数病例（71.4%）为扁平隆起型，其余息肉（28.6%）为无蒂型。大多数息肉（85.7%）有黏液帽。除1例（85.7%）外，所有病例均显示BRAF-V600E突变。我们的研究结果是，SSA/Ps可出现中央凹陷，尽管此类病例罕见。除了存在凹陷表面和明显的男性优势外，呈凹陷表面的SSA/Ps的内镜和临床病理特征似乎与普通SSA/Ps相似。虚拟切片：本文的虚拟切片可在此处找到：http://www.diagnosticpathology.diagnomx.eu/vs/1562070886167874 。
