Chen Yu-Cong, Huang Yung-Ning, Lu Yang-Bor
Department of Digestive Disease, Xiamen Chang Gung Hospital, Hua Qiao University, Xiamen, CHN.
Cureus. 2024 Dec 24;16(12):e76305. doi: 10.7759/cureus.76305. eCollection 2024 Dec.
We present the case of a 68-year-old woman who underwent complete endoscopic resection of a superficial serrated adenoma (SuSA). Due to its rarity and limited case reports, SuSA is often misdiagnosed as a hyperplastic lesion without malignant potential, leading to missed diagnoses. A polypoid lesion was identified in the sigmoid colon during the initial endoscopic evaluation, where it was initially classified as a sessile serrated lesion (SSL). The subsequent endoscopic evaluation, using crystal violet staining, revealed a type IIIL pit pattern. Endoscopic mucosal resection (EMR) was performed, and histopathological analysis confirmed serrated glandular hyperplasia with mild atypia. Immunohistochemical staining showed cytokeratin 20 (CK20) expression predominantly in the upper layer, while Ki-67 and cellular myelocytomatosis oncogene (c-MYC) were distributed in the basal and intermediate layers. Beta-catenin positivity was observed in the cytoplasm of some nuclei, confirming the diagnosis of SuSA. This case underscores the importance of timely recognition and management of SuSA to prevent progression to more severe conditions.
我们报告了一例68岁女性患者，该患者接受了浅表锯齿状腺瘤（SuSA）的完整内镜下切除术。由于其罕见性及病例报告有限，SuSA常被误诊为无恶性潜能的增生性病变，导致漏诊。在初次内镜评估时，在乙状结肠发现一个息肉样病变，最初将其分类为无蒂锯齿状病变（SSL）。随后使用结晶紫染色进行的内镜评估显示为IIIL型凹坑模式。进行了内镜黏膜切除术（EMR），组织病理学分析证实为伴有轻度异型性的锯齿状腺增生。免疫组织化学染色显示细胞角蛋白20（CK20）主要在上层表达，而Ki-67和细胞髓细胞瘤癌基因（c-MYC）分布在基底层和中间层。在一些细胞核的细胞质中观察到β-连环蛋白阳性，从而确诊为SuSA。该病例强调了及时识别和处理SuSA以防止进展为更严重疾病的重要性。
