Serrated neoplasia of the stomach: a new entity

Rubio, Carlos A.

doi:10.1136/jcp.54.11.849

Cited by 20 publications

(24 citation statements)

References 23 publications

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“…Limited reports focused on the clinical features of UPGI serrated lesions because of the low prevalence of these lesions, and few articles have described serrated adenomas in the UPGI[7-25]. Thus, serrated polyps have not been previously listed in the classifications of the upper digestive tract[34-36].…”

Section: Discussionmentioning

confidence: 99%

“…In 1992, Stolte et al[6] revealed a characteristic “hypertrophy” of the parietal cells that was induced by omeprazole, and produced a serrated internal gland profile. In addition, in 2001, Rubio[7] reported the first case of serrated adenoma of the stomach. Since then, serrated dysplasia has been reported in patients with Ménétrier-like lymphocytic gastritis[8], reactive gastropathy[9] and even Barrett’s esophagus[10], and it is epitomised by hypereosinophilic cytoplasm, small oval-shaped nuclei and prominent luminal serration.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients

Cao

Dong

et al. 2016

WJG

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AIMTo analyse the clinical features of patients with the serrated lesions in the upper gastrointestinal tract (UPGI) tract.METHODSPatients who underwent routine esophagogastroduodenoscopy (EGD) at the Digestive Endoscopy Centre of General Hospital, Tianjin Medical University between January 2011 and December 2015 were consecutively recruited. Patients with UPGI serrated lesions were consecutively identified. The patients’ demographics and histopathology were recorded. The colorectal findings for patients who underwent colonoscopy simultaneously or within six months were also extracted from the colonoscopy database. In addition, we analysed differences in colorectal neoplasia detection between the study patients and randomly selected patients matched for age and gender who did not exhibit serrated lesions and who also underwent colonoscopy in the same period.RESULTSA total of 21 patients out of 98746 patients (0.02%) who underwent EGD were confirmed to have serrated lesions with predominantly crenated, sawtooth-like configurations. The mean age of the 21 patients was (55.3 ± 17.2) years, and 11 patients were male (52.4%). In terms of the locations of the serrated lesions, 17 were found in the stomach (including 3 in the cardia, 9 in the corpus and 5 in the antrum), 3 were found in the duodenum, and 1 was found in the esophagus. Serrated lesions were found in different mucosal lesions, with 14 lesions were detected in polyps (8 hyperplastic polyps and 6 serrated adenomas with low grade dysplasia), 3 detected in Ménétrier gastropathy, 3 detected in an area of inflammation or ulcer, and 1 detected in the intramucosal carcinoma of the duodenum. In addition, colonoscopy data were available for 18 patients, and a significantly higher colorectal adenoma detection rate was observed in the UPGI serrated lesions group than in the randomly selected age- and gender-matched group without serrated lesions who also underwent colonoscopy in the same period (38.9% vs 11.1%, OR = 5.091, 95%CI: 1.534-16.890, P = 0.010). The detection rate of advanced adenoma was also higher in the UPGI serrated lesions group (22.2% vs 4.2%, OR = 6.571, 95%CI: 1.322-32.660, P = 0.028).CONCLUSIONSerrated lesions in the UPGI were detected in various mucosal lesions with different pathological morphologies. Moreover colonoscopy is recommended for the detection of concurrent colorectal adenoma for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients

Cao

Dong

et al. 2016

WJG

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“…Gastric localization is quite rare with only six cases reported in English literature [12, 13]. In this report, we will present a serrated adenoma localized in gastric antrum which had follow up biopsies and we will discuss the altered mucin expression of the lesion which may have a possible role in its carcinogenetic pathway.…”

Section: Introductionmentioning

confidence: 94%

Serrated Adenoma of Gastric Antrum: Alteration of Mucin Expression Profile and its Role in Carcinogenesis

2009

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Serrated adenomas usually occur in colon, the gastric localization is extremely rare. These polyps have their own carcinogenetic pathway with microsatellite instability. In this report, we present a serrated adenoma localized in gastric antrum with four control endoscopies and biopsies. Immunohistochemical panel of MUC1, MUC2, MUC5AC, and MUC6 was applied to the biopsies. Serrated component, MUC 2 expression increased but goblet cells and MUC5AC expression decreased in follow-up biopsies. This lesion probably was originated from a stem cell that had the potential of differentiation in gastric and intestinal way. This might result an incomplete metaplasia for both colon and stomach. Such lesions which originate from either colon or gastric mucosa may be precancerous and their carcinogenetic pathway may not represent its original organ.

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“…It had the microscopic attributes of a sporadic serrated adenoma, a tumour that is relatively common in the colorectal mucosa, 8 9 and is occasionally reported in the stomach. 10 ''Recently, while reviewing partial duodenectomy specimens we found one patient with FAP who had a duodenal adenoma with a histological configuration that differed from those previously described in the literature''…”

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confidence: 94%

Serrated adenoma of the duodenum

Rubio

2004

J Clin Pathol

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The duodenum is the most common site for extracolonic adenomas in patients with familial adenomatous polyposis (FAP). These adenomas are usually tubular, villous, or tubulovillous. This report describes a patient with FAP who had a duodenal adenoma with a different histology-it had the microscopic attributes of a serrated adenoma-tumours that are relatively common in the colorectal mucosa and are occasionally found in the stomach. A 78 year old man with FAP and multiple adenomas was colectomised and the rectum amputated. Several years later he developed silent jaundice. The surgical specimen showed an adenomatous growth juxtaposing the papilla of Vater. The adenoma had epithelial fronds with crenated, sawtooth-like configurations caused by scalloped epithelial infolding. The nuclei covering the notched fronds were pleomorphic, stratified, either cigar shaped with irregular chromatin deposits or vesicular shaped with a large nucleolus. One area showed involvement of a duct by neoplastic epithelium with extension into periluminal glands. No invasive carcinoma was present. Serrated adenomas differ from tubular and villous adenomas in their histological organisation and their initial pattern of cell proliferation and genotypic aberration. Increased awareness of the existence of serrated neoplasms in the duodenum may result in similar cases being reported in the future.

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Serrated neoplasia of the stomach: a new entity

Cited by 20 publications

References 23 publications

Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients

Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients

Serrated Adenoma of Gastric Antrum: Alteration of Mucin Expression Profile and its Role in Carcinogenesis

Serrated adenoma of the duodenum

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