Journal of Pathology and Translational Medicine

Case Report

Solitary Peutz-Jeghers type harmartomatous polyp in duodenum with gastric foveolar epithelium: a case report: Eugene Choi, Junghwan Lee, Youngsoo Park; J Pathol Transl Med. 2023;57(2):128-131. Published online January 10, 2023; DOI: https://doi.org/10.4132/jptm.2022.11.07

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Abstract PDF: Peutz-Jeghers type hamartomatous polyp is known to be associated with Peutz-Jeghers syndrome, which shows characteristic multiple hamartomatous polyp involvement in the gastrointestinal tract, combined with mucocutaneous symptom, familial history of Peutz- Jeghers syndrome or STK11/LTB1 mutation. However, some cases showing histologic appearance of the polyps discovered in Peutz- Jeghers syndrome while lacking other diagnostic criteria of the syndrome have been reported, and these are called solitary Peutz- Jeghers type polyps. Herein, we report a case of solitary Peutz-Jeghers type polyp covered with heterotopic epithelium. The patient was 47-year-old female without any mucocutaneous symptoms nor familial history of Peutz-Jeghers syndrome. Microscopic examination revealed Peutz-Jeghers type hamartomatous polyp in duodenum covered with gastric type foveolar epithelium. Considering the definition of hamartomatous polyp, which is, the abnormal overgrowth of the indigenous epithelial component, the histological feature of current case is noteworthy in a point that it shows proliferation of heterotopic component, rather than the indigenous component.

Review

Evolving pathologic concepts of serrated lesions of the colorectum: Jung Ho Kim, Gyeong Hoon Kang; J Pathol Transl Med. 2020;54(4):276-289. Published online June 26, 2020; DOI: https://doi.org/10.4132/jptm.2020.04.15

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Here, we provide an up-to-date review of the histopathology and molecular pathology of serrated colorectal lesions. First, we introduce the updated contents of the 2019 World Health Organization classification for serrated lesions. The sessile serrated lesion (SSL) is a new diagnostic terminology that replaces sessile serrated adenoma and sessile serrated polyp. The diagnostic criteria for SSL were revised to require only one unequivocal distorted serrated crypt, which is sufficient for diagnosis. Unclassified serrated adenomas have been included as a new category of serrated lesions. Second, we review ongoing issues concerning the morphology of serrated lesions. Minor morphologic variants with distinct molecular features were recently defined, including serrated tubulovillous adenoma, mucin-rich variant of traditional serrated adenoma (TSA), and superficially serrated adenoma. In addition to intestinal dysplasia and serrated dysplasia, minimal deviation dysplasia and not otherwise specified dysplasia were newly suggested as dysplasia subtypes of SSLs. Third, we summarize the molecular features of serrated lesions. The critical determinant of CpG island methylation development in SSLs is patient age. Interestingly, there may be ethnic differences in BRAF/KRAS mutation frequencies in SSLs. The molecular pathogenesis of TSAs is divided into KRAS and BRAF mutation pathways. SSLs with MLH1 methylation can progress into favorable prognostic microsatellite instability-positive (MSI+)/CpG island methylator phenotype-positive (CIMP+) carcinomas, whereas MLH1-unmethylated SSLs and BRAF-mutated TSAs can be precursors of poor-prognostic MSI−/CIMP+ carcinomas. Finally, based on our recent data, we propose an algorithm for stratifying risk subgroups of non-dysplastic SSLs.

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NTRK oncogenic fusions are exclusively associated with the serrated neoplasia pathway in the colorectum and begin to occur in sessile serrated lesions
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Original Article

Colorectal epithelial neoplasm associated with gut-associated lymphoid tissue: Yo Han Jeon, Ji Hyun Ahn, Hee Kyung Chang; J Pathol Transl Med. 2020;54(2):135-145. Published online January 29, 2020; DOI: https://doi.org/10.4132/jptm.2019.11.06

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Abstract PDF: Background
Colorectal epithelial neoplasm extending into the submucosal gut-associated lymphoid tissue (GALT) can cause difficulties in the differential diagnosis. Regarding GALT-associated epithelial neoplasms, a few studies favor the term “GALT carcinoma” while other studies have mentioned the term “GALT-associated pseudoinvasion/epithelial misplacement (PEM)”.
Methods
The clinicopathologic characteristics of 11 cases of colorectal epithelial neoplasm associated with submucosal GALT diagnosed via endoscopic submucosal dissection were studied.
Results
Eight cases (72.7%) were in males. The median age was 59 years, and age ranged from 53 to 73. All cases had a submucosal tumor component more compatible with GALT-associated PEM. Eight cases (72.7%) were located in the right colon. Ten cases (90.9%) had a non-protruding endoscopic appearance. Nine cases (81.8%) showed continuity between the submucosal and surface adenomatous components. Nine cases showed (81.8%) focal defects or discontinuation of the muscularis mucosae adjacent to the submucosal GALT. No case showed hemosiderin deposits in the submucosa or desmoplastic reaction. No case showed single tumor cells or small clusters of tumor cells in the submucosal GALT. Seven cases (63.6%) showed goblet cells in the submucosa. No cases showed oncocytic columnar cells lining submucosal glands.
Conclusions
Our experience suggests that pathologists should be aware of the differential diagnosis of GALT-associated submucosal extension by colorectal adenomatous neoplasm. Further studies are needed to validate classification of GALT-associated epithelial neoplasms.

Case Report

Rectal Invasion by Prostatic Adenocarcinoma That Was Initially Diagnosed in a Rectal Polyp on Colonoscopy: Ghilsuk Yoon, Man-Hoon Han, An Na Seo; J Pathol Transl Med. 2019;53(4):266-269. Published online April 11, 2019; DOI: https://doi.org/10.4132/jptm.2019.03.25

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Abstract PDF

Despite anatomical proximity, prostatic adenocarcinoma with rectal invasion is extremely rare. We present a case of rectal invasion by prostatic adenocarcinoma that was initially diagnosed from a rectal polyp biopsied on colonoscopy in a 69-year-old Korean man. He presented with dull anal pain and voiding discomfort for several days. Computed tomography revealed either prostatic adenocarcinoma with rectal invasion or rectal adenocarcinoma with prostatic invasion. His tumor marker profile showed normal prostate specific antigen (PSA) level and significantly elevated carcinoembryonic antigen level. Colonoscopy was performed, and a specimen was obtained from a round, 1.5 cm, sessile polyp that was 1.5 cm above the anal verge. Microscopically, glandular tumor structures infiltrated into the rectal mucosa and submucosa. Immunohistochemically, the tumor cells showed alpha-methylacyl-CoA-racemase positivity, PSA positivity, and caudal-related homeobox 2 negativity. The final diagnosis of the rectal polyp was consistent with prostatic adenocarcinoma. Here, we present a rare case that could have been misdiagnosed as rectal adenocarcinoma.

Citations

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An Interesting Case of Prostate Cancer Presenting With Colonic Metastasis
Shawn Keating, Ayesha Imtiaz, Kenneth Nahum, Ankita Prasad, Pramil Cheriyath
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Guillaume Abitbol, Clémence Barthomeuf, Olivier Varennes, Marine Clement, Sami Hakim, Denis Chatelain
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Original Article

CpG Island Methylation in Sessile Serrated Adenoma/Polyp of the Colorectum: Implications for Differential Diagnosis of Molecularly High-Risk Lesions among Non-dysplastic Sessile Serrated Adenomas/Polyps: Ji Ae Lee, Hye Eun Park, Seung-Yeon Yoo, Seorin Jeong, Nam-Yun Cho, Gyeong Hoon Kang, Jung Ho Kim; J Pathol Transl Med. 2019;53(4):225-235. Published online March 19, 2019; DOI: https://doi.org/10.4132/jptm.2019.03.12

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Abstract PDF Supplementary Material

Background
Although colorectal sessile serrated adenomas/polyps (SSA/Ps) with morphologic dysplasia are regarded as definite high-risk premalignant lesions, no reliable grading or risk-stratifying system exists for non-dysplastic SSA/Ps. The accumulation of CpG island methylation is a molecular hallmark of progression of SSA/Ps. Thus, we decided to classify non-dysplastic SSA/Ps into risk subgroups based on the extent of CpG island methylation.
Methods
The CpG island methylator phenotype (CIMP) status of 132 non-dysplastic SSA/Ps was determined using eight CIMP-specific promoter markers. SSA/Ps with CIMP-high and/or MLH1 promoter methylation were regarded as a high-risk subgroup.
Results
Based on the CIMP analysis results, methylation frequency of each CIMP marker suggested a sequential pattern of CpG island methylation during progression of SSA/P, indicating MLH1 as a late-methylated marker. Among the 132 non-dysplastic SSA/Ps, 34 (26%) were determined to be high-risk lesions (33 CIMP-high and 8 MLH1-methylated cases; seven cases overlapped). All 34 high-risk SSA/Ps were located exclusively in the proximal colon (100%, p = .001) and were significantly associated with older age (≥ 50 years, 100%; p = .003) and a larger histologically measured lesion size (> 5 mm, 100%; p = .004). In addition, the high-risk SSA/Ps were characterized by a relatively higher number of typical base-dilated serrated crypts.
Conclusions
Both CIMP-high and MLH1 methylation are late-step molecular events during progression of SSA/Ps and rarely occur in SSA/Ps of young patients. Comprehensive consideration of age (≥ 50), location (proximal colon), and histologic size (> 5 mm) may be important for the prediction of high-risk lesions among non-dysplastic SSA/Ps.

Citations

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Serrated Colorectal Lesions: An Up-to-Date Review from Histological Pattern to Molecular Pathogenesis
Martino Mezzapesa, Giuseppe Losurdo, Francesca Celiberto, Salvatore Rizzi, Antonio d’Amati, Domenico Piscitelli, Enzo Ierardi, Alfredo Di Leo
International Journal of Molecular Sciences.2022; 23(8): 4461. CrossRef
NTRK oncogenic fusions are exclusively associated with the serrated neoplasia pathway in the colorectum and begin to occur in sessile serrated lesions
Jung Ho Kim, Jeong Hoon Hong, Yoon‐La Choi, Ji Ae Lee, Mi‐kyoung Seo, Mi‐Sook Lee, Sung Bin An, Min Jung Sung, Nam‐Yun Cho, Sung‐Su Kim, Young Kee Shin, Sangwoo Kim, Gyeong Hoon Kang
The Journal of Pathology.2021; 255(4): 399. CrossRef
Evolving pathologic concepts of serrated lesions of the colorectum
Jung Ho Kim, Gyeong Hoon Kang
Journal of Pathology and Translational Medicine.2020; 54(4): 276. CrossRef

Case Study

A Case of Giant Colonic Muco-submucosal Elongated Polyps Associated with Intussusception: Joo Heon Kim, Seung Yun Lee, Je Ho Jang, Hyun Young Han, Dong Wook Kang; J Pathol Transl Med. 2016;50(6):474-478. Published online May 23, 2016; DOI: https://doi.org/10.4132/jptm.2016.04.27

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Abstract PDF

Colonic muco-submucosal elongated polyp (CMSEP), a newly categorized non-neoplastic colorectal polyp, is a pedunculated and elongated polyp composed of normal mucosal and submucosal layers without any proper muscle layer. We herein report a giant variant of CMSEP associated with intussusception in the rectosigmoid colon, with a review of the literature. A 48-year-old woman underwent a laparoscopic low anterior resection due to multiple large submucosal polypoid masses associated with intussusception. Grossly, the colonic masses were multiple pedunculated polyps with a long stalk and branches ranging in size from a few millimeters to 14.0 cm in length. Microscopically, there was no evidence of hyperplasia, atypia, or active inflammation in the mucosa. The submucosal layers were composed of edematous and fibrotic stroma with fat tissue, dilated vessels, and lymphoid follicles.

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Multiple enteric muco-submucosal elongated polyps causing intussusception
Atsuki Taniguchi, Izuru Endo, Takeyoshi Nishiyama, Nobuyuki Watanabe, Osamu Yoshida, Hiroaki Asano, Masatoshi Kubo, Tetsunobu Udaka
Clinical Journal of Gastroenterology.2024; 17(1): 41. CrossRef
Jejunal intussusception and perforation due to enteric muco-submucosal elongated polyp: a case report and literature review
Ryosuke Kikuchi, Shigenobu Emoto, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shinya Abe, Hirofumi Sonoda, Aya Shinozaki-Ushiku, Soichiro Ishihara
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A stalk with no polyp—A muco‐submucosal elongated polyp in the duodenum
Neil O’Morain, Ciaran McCloskey, Sinead Flanagan, Glen Doherty
United European Gastroenterology Journal.2023; 11(4): 392. CrossRef
Duodenal Worm-Like Polyp
Pan Pan, Guoshan Zhang, Xiao Cui, Liang Liu
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Original Article

Investigation of the Roles of Cyclooxygenase-2 and Galectin-3 Expression in the Pathogenesis of Premenopausal Endometrial Polyps: Esin Kasap, Serap Karaarslan, Esra Bahar Gur, Mine Genc, Nur Sahin, Serkan Güclü; J Pathol Transl Med. 2016;50(3):225-230. Published online April 16, 2016; DOI: https://doi.org/10.4132/jptm.2016.03.08

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Abstract PDF

Background
The pathogenesis and etiology of endometrial polyps has not been elucidated. In this study, we aimed to examine the pathogenic mechanisms of endometrial polyp development using immunohistochemistry. We evaluated the expression of galectin-3 and cyclooxgenase-2 (COX-2) during the menstrual cycle in premenopausal women with endometrial polyps or normal endometrium.
Methods
Thirty-one patients with endometrial polyps and 50 healthy control patients were included in this study. The levels of expression of COX-2 and galectin-3 were studied by immunohistochemistry.
Results
The percentage of COX-2–positive cells and the intensity of COX-2 staining in the endometrium did not vary during the menstrual cycle either in the control group or in patients with endometrial polyps. However, expression of galectin-3 was significantly lower in endometrial polyps and during the proliferative phase of the endometrium compared with the secretory phase.
Conclusions
Our data suggests that the pathogenesis of endometrial polyps does not involve expression of COX-2 or galectin-3.

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Review

Ménétrier’s Disease: Its Mimickers and Pathogenesis: Won Jae Huh, Robert J. Coffey, Mary Kay Washington; J Pathol Transl Med. 2016;50(1):10-16. Published online December 18, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.15

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Abstract PDF

Ménétrier’s disease is a rare protein-losing hypertrophic gastropathy. Histologically, it can be mistaken for other disorders showing hypertrophic gastropathy. The pathogenesis of Ménétrier’s disease is not fully understood; however, it appears that the epidermal growth factor receptor (EGFR) ligand, transforming growth factor alpha, contributes to the pathogenesis of this disorder. In this review, we will discuss disease entities that can mimic Ménétrier’s disease and the role of EGFR signaling in Ménétrier’s disease.

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Case Study

Follicular Dendritic Cell Sarcoma of the Inflammatory Pseudotumor-like Variant Presenting as a Colonic Polyp: Shien-Tung Pan, Chih-Yuan Cheng, Nie-Sue Lee, Peir-In Liang, Shih-Sung Chuang; Korean J Pathol. 2014;48(2):140-145. Published online April 28, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.2.140

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Abstract PDF

Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.

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Case Reports

Cellular Pseudosarcomatous Fibroepithelial Stromal Polyp of the Vagina during Pregnancy: A Lesion That Is Overdiagnosed as a Malignant Tumor: Joon Seon Song, Dong Eun Song, Kyu-Rae Kim, Jae Y. Ro; Korean J Pathol. 2012;46(5):494-498. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.494

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Abstract PDF

Fibroepithelial stromal polyp (FSP) is a benign lesion that can occur at various sites, including the lower female genital tract. In rare cases, however, it may exhibit hypercellularity, bizarre cytomorphological features, and atypical mitoses resulting in an overdiagnosis as a malignant tumor despite its benign clinical course. Recently, we experienced one case of a 30-year-old pregnant woman with cellular pseudosarcomatous FSP that was initially diagnosed as a malignant fibrous histiocytoma at a primary clinic. In addition to describing the rare features of this case, we wish to increase awareness about this benign lesion which will be essential for avoiding unnecessary radical surgery or chemoradiation treatment.

Citations

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Cureus.2024;[Epub] CrossRef
Recurrent fibroepithelial vaginal polyp in a 2-year-old girl: a case report and review of the literature
Mohammad Hakam Shehadeh, Ahmad M. Abualrub, Waleed M. Malhes, Amar Msarweh, Wael Amro
Annals of Medicine & Surgery.2024; 86(4): 2335. CrossRef
A vaginal fibroepithelial stromal polyp: a case report with magnetic resonance images
Naoko Ogura, Mieko Inagaki, Ritsuko Yasuda, Shigeki Yoshida, Tetsuo Maeda
BJR|case reports.2022;[Epub] CrossRef
Fast-growing fibroepithelial stromal vaginal polyp
Ana Marta Pinto, Maria Boia Martins, Isabel Ferreira, Clara Moreira
BMJ Case Reports.2022; 15(6): e250076. CrossRef
Giant hypopharyngeal fibroepithelial polyp: A case report and literature review
Muhammad Nour Alabdullah, Nagham Halaweek, Yasser Al Ghabra, Mohammad Hamdi, Mhd Ayham Abo Trab, Faysal Hajjar
Ear, Nose & Throat Journal.2022; : 014556132211467. CrossRef
Mesenchymal lesions of the vulva
David B. Chapel, Nicole A. Cipriani, Jennifer A. Bennett
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Giant Fibroepithelial Stromal Polyp of the Vulva: Diffusion-Weighted and Conventional Magnetic Resonance Imaging Features and Pathologic Correlation
Joonghyun Yoo, Bo-Kyung Je, Suk Keu Yeom, Ye Sul Park, Kyung-Jin Min, Joo Han Lee
Journal of Pediatric and Adolescent Gynecology.2019; 32(1): 93. CrossRef
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Ruquiya Afrose
Advances in Cytology & Pathology.2018;[Epub] CrossRef
Pseudosarcomatous Vaginal Polyp
Alexis Heller, Adanna Ukazu, Qing Wang
International Journal of Surgical Pathology.2017; 25(1): 54. CrossRef

Multifocal Adenocarcinomas Arising within a Gastric Inverted Hyperplastic Polyp: Hyun-Soo Kim, Eun-Jung Hwang, Jae-Young Jang, Juhie Lee, Youn Wha Kim; Korean J Pathol. 2012;46(4):387-391. Published online August 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.387

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Abstract PDF

We present herein the occurrence of multifocal adenocarcinomas with a minute signet ring cell carcinoma that arose within a gastric inverted hyperplastic polyp (IHP) in a 40-year-old woman. Endoscopic ultrasonography demonstrated a heterogeneous hypoechoic mass in the third layer of the gastric wall. The endoscopic submucosal dissection specimen measuring 3.5×3.2×1.8 cm was a well-circumscribed protruding lesion that had a slit-shaped cavity. Histologically, the lesion consisted mainly of endophytic proliferation of hyperplastic columnar cells resembling normal foveolar epithelium. In addition, six foci of adenocarcinomas and a minute focus of signet ring cell carcinoma were randomly distributed in the superficial and deep regions. The adenocarcinoma was gradually transitioning from dysplasia, while the signet ring cell carcinoma was surrounded by hyperplastic foveolar epithelium. This is the first report of a gastric IHP with multifocal intramucosal adenocarcinomas and a signet ring cell carcinoma, and endoscopic submucosal dissection is used to completely resect it.

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Clinicopathologic and endoscopic characteristics of ten patients with gastric hamartomatous inverted polyp: a single center case series
Ningning Dong, Fandong Meng, Bing Yue, Junzhen Hou
BMC Gastroenterology.2024;[Epub] CrossRef
Gastric hamartomatous inverted polyp: Report of three cases with a review of the endoscopic and clinicopathological features
Takuya Ohtsu, Yu Takahashi, Mitsuo Tokuhara, Tomomitsu Tahara, Mitsuaki Ishida, Chika Miyasaka, Koji Tsuta, Makoto Naganuma
DEN Open.2023;[Epub] CrossRef
Gastric Inverted Hyperplastic Polyp Removed Using Endoscopic Submucosal Dissection
Jee Won Boo, Joon Sung Kim, Byung-Wook Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(1): 63. CrossRef
The Many Faces of Gastric Inverted Polyps: a case report
S.I. Kim, M.Y. Agapov, T.F. Savostyanov, A.A. Paratovskaya, I.A. Sokolova
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Large gastric hamartomatous inverted polyp accompanied by advanced gastric cancer: A case report
Gyerim Park, Jihye Kim, Sung Hak Lee, Younghoon Kim
World Journal of Clinical Cases.2023; 11(28): 6967. CrossRef
Activating KRAS and GNAS mutations in heterotopic submucosal glands of the stomach
Hourin Cho, Taiki Hashimoto, Tomoaki Naka, Yasushi Yatabe, Ichiro Oda, Yutaka Saito, Takaki Yoshikawa, Shigeki Sekine
Journal of Gastroenterology.2022; 57(5): 333. CrossRef
Gastric Inverted Polyps—Distinctive Subepithelial Lesions of the Stomach
Ji-Ye Kim, Soomin Ahn, Kyoung-Mee Kim, Sun Hee Chang, Han Seong Kim, Jun Haeng Lee, Jae J. Kim, Tae Sung Sohn, Hye Ju Kang, Mee Joo
American Journal of Surgical Pathology.2021; 45(5): 680. CrossRef
Signet-ring Cell Carcinoma in Hyperplastic Polyp of the Stomach
Kenta Yoshida, Tatsuya Mikami, Takao Oyama, Yuki Sato, Taro Saito, Takafumi Mikami, Chieko Itabashi, Yasushi Soma, Shinsaku Fukuda
Internal Medicine.2019; 58(24): 3531. CrossRef
Inverted Hyperplastic Polyp in Stomach: A Case Report and Literature Review
Yeon Ho Lee, Moon Kyung Joo, Beom Jae Lee, Ji-Ae Lee, Taehyun Kim, Jin Gu Yoon, Jung Min Lee, Jong-Jae Park
The Korean Journal of Gastroenterology.2016; 67(2): 98. CrossRef
Inflammatory myofibroblastic tumor‐like stromal proliferation within gastric inverted hyperplastic polyp
Byeong‐Joo Noh, Ji Won Min, Ji‐Youn Sung, Yong‐Koo Park, Juhie Lee, Youn Wha Kim
Pathology International.2016; 66(3): 180. CrossRef
Gastric inverted hyperplastic polyp: A rare cause of iron deficiency anemia
Jin Tak Yun, Seung Woo Lee, Dong Pil Kim, Seung Hwa Choi, Seok-Hwan Kim, Jun Kyu Park, Sun Hee Jang, Yun Jung Park, Ye Gyu Sung, Hae Jung Sul
World Journal of Gastroenterology.2016; 22(15): 4066. CrossRef
Gastric Inverted Hyperplasic Polyp Composed Only of Pyloric Glands
Minsun Jung, Kyueng-Whan Min, Young-Joon Ryu
International Journal of Surgical Pathology.2015; 23(4): 313. CrossRef
A Pedunculated Submucosal Lesion in the Stomach with Inverted Downgrowth
Yoshihiko Miyamoto, Naoki Muguruma, Seisuke Okamura, Yasuyuki Okada, Shinji Kitamura, Koichi Okamoto, Akiko Yoneda, Noriko Kagawa, Tetsuji Takayama
Internal Medicine.2014; 53(15): 1625. CrossRef

Original Article

Clinicopathologic Characteristics of Left-Sided Colon Cancers with High Microsatellite Instability.: Sang Kyum Kim, Junjeong Choi, Hyun Ki Kim, Young Nyun Park, Si Young Song, Hoguen Kim; Korean J Pathol. 2009;43(5):428-434.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.428

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Abstract PDF

BACKGROUND
High microsatellite instability (MSI-H) colorectal carcinomas (CRCs) with numerous mutations in the microsatellite sequence are characterized by a right-sided preponderance, frequent peritumoral and intratumoral lymphocytic infiltration, and frequent mucin production. However, no study has correlated anatomic site and type of genetic changes with clinicopathologic changes.
METHODS
We analyzed the histopathologic features of 135 MSI-H CRCs and compared them to 140 microsatellite stable (MSS) CRCs. Histopathologic changes in MSI-H were further analyzed according to anatomic sites and genetic changes.
RESULTS
MSI-H CRCs showed previously reported clinicopathologic findings; a right-sided preponderance, an increased number of mucinous carcinomas, and peritumoral lymphoid reactions (p<0.001 for each variable). Increased serum CEA levels showed an MSS CRC preponderance (p=0.013). We further analyzed the histologic differences between right- and left-sided MSI-H tumors. We found that MSI-H CRCs on both sides had similar clinicopathologic findings, except for higher tumor stage (p=0.048) and less frequent abnormal CEA levels in left-sided MSI-H tumors (p=0.027). We found that not all clinicopathologic features were different between hereditary nonpolyposis colorectal cancers (HNPCCs) and sporadic MSI-H CRCs.
CONCLUSIONS
These findings indicate that MSI-H CRCs of the left colon have similar clinicopathologic characteristics as right-sided MSI-H CRCs. We did not find any significant clinicopathological difference between HNPCCs and sporadic MSI-H CRCs.

Citations

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Fibroblast Growth Factor Receptor 1 Gene Copy Number and mRNA Expression in Primary Colorectal Cancer and Its Clinicopathologic Correlation
Yoonjin Kwak, Soo Kyung Nam, An Na Seo, Duck-Woo Kim, Sung-Bum Kang, Woo Ho Kim, Hye Seung Lee
Pathobiology.2015; 82(2): 76. CrossRef

Case Reports

Gastrointestinal Stromal Tumor of the Colon Mimicking Inflammatory Fibroid Polyp with a Novel 63 bp c-kit Deletion Mutation: A Case Report.: In Gu Do, Cheol Keun Park, Sung Hyun Yoon, John Goldblum, Kyoung Mee Kim; Korean J Pathol. 2009;43(4):374-377.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.374

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Abstract PDF: Colonic gastrointestinal stromal tumors (GISTs) are rare and behave aggressively compared to GISTs in other parts of the gastrointestinal tract. Therefore, accurate diagnosis of GISTs and their distinction from other mesenchymal tumors is important for proper patient management and follow-up. Herein, we present an unusual case of a colonic GIST mimicking an inflammatory fibroid polyp with a novel 63 bp deletion mutation in exon 11 of the c-kit gene, which has not previously been reported. The tumor consisted of loosely arranged spindle cells and many inflammatory cells scattered throughout the tumor. Immunohistochemically, the tumor cells were focally and weakly positive for c-kit and diffusely positive for CD34, but were negative for PKC-theta, SMA, S-100 protein, ALK-1, and desmin. Our case re-emphasizes the broad morphologic spectrum of GISTs.

Ureteral Fibroepithelial Polyp: A report of four cases (One case with nephrogenic adenoma).: Won Mee Lee, Seung Sam Paik, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee; Korean J Pathol. 1996;30(8):715-720.

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Abstract PDF: Fibroepithelial polyps of the ureter are usually acquired rather than congenital. Most polyps are hamartomatous growths which tend to arise in the proximal portion of the left ureter. Most patients exibit either hematuria or persistent flank pain secondary to partial ureteral obstruction. Because of false positivity of urine cytology, as well as intravenous pyelogram, the correct diagnosis is confused with malignancy. Herein we report four cases of ureteral fibroepithelial polyp, which are associated with stones resulting in partial obstruction of the ureter. One of the four cases is associated with nephrogenic adenoma in the lamina propria of the adjacent ureter. The following report describes clinicopathologic findings of fibroepithelial polyp with review of literatures.

Atypical Polypoid Adenomyomas of the Endometrium: 2 case reports.: Hee Jeong Ahn, Kyu Rae Kim, Yoon Jung Choi, Bok Soo Kim; Korean J Pathol. 1996;30(11):1034-1039.

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Abstract PDF: Atypical polypoid adenomyoma(APA) is a rare benign polypoid tumor arising in the uterine endometrium which was first designated by Mazur in 1981. Microscopic examination reveals architecturally and cytologically atypical endometrial glands separated by intersecting fascicles of smooth muscle cells. The tumor can be misdiagnosed as endometrial adenocarcinoma with myometrial invasion, especially on microscopic examination of a curettage specimen. However a granulation tissue-like stromal response is absent and the smooth muscle in APA is more cellular than that of normal myometrium. We are reporting 2 cases of APA of the uterine endometrium which are 1.5 cm and 1.7 cm in size, respectively, in a 30 and a 22 year-old women. This is the first report in Korean literature using the immunohistochemical staining for smooth muscle actin and desmin.

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