Prognostic significance of high grade dysplasia in colorectal adenomas.
Summary of "Prognostic significance of high grade dysplasia in colorectal adenomas."
Method A search of patients who had had endoscopic removal of an high grade adenoma was carried out. Patients with the following were excluded: follow-up of less than 1 year, polyposis syndromes, prior colon cancer, and a diagnosis of adenocarcinoma within 6 months following initial diagnosis. Results: 83 patients treated between 1999-2007 for high-grade dysplasia in a colorectal adenoma were identified. Over a median follow up period of 4 years, 53 (64%) developed further adenomatous polyps. Among these, 7% has an adenoma with high-grade dysplasia or an adenocarcinoma. In all these cases the initial high grade adenoma was >1 cm in diameter. Initial follow-up colonoscopy was performed on average 7 months following the initial diagnosis. 10% of patients underwent prophylactic segmental resection and 6% received argon laser therapy. Conclusion: The study demonstrates that patients who have a colorectal adenoma > 1 cm with high-grade dysplasia may be at high risk of developing further adenomas with high- grade dysplasia or carcinoma. Close follow up is warranted.
Pathology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
This article was published in the following journal.
Name: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20718835
- DOI: http://dx.doi.org/10.1111/j.1463-1318.2010.02385.x
Medical and Biotech [MESH] Definitions
Aberrant Crypt Foci
Clusters of colonic crypts that appear different from the surrounding mucosa when visualized after staining. They are of interest as putative precursors to colorectal adenomas and potential biomarkers for colorectal carcinoma.
A tumor of both low- and high-grade malignancy. The low-grade grow slowly, appear in any age group, and are readily cured by excision. The high-grade behave aggressively, widely infiltrate the salivary gland and produce lymph node and distant metastases. Mucoepidermoid carcinomas account for about 21% of the malignant tumors of the parotid gland and 10% of the sublingual gland. They are the most common malignant tumor of the parotid. (From DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p575; Holland et al., Cancer Medicine, 3d ed, p1240)
Colorectal Neoplasms, Hereditary Nonpolyposis
A group of autosomal-dominant inherited diseases in which COLON CANCER arises in discrete adenomas. Unlike FAMILIAL POLYPOSIS COLI with hundreds of polyps, hereditary nonpolyposis colorectal neoplasms occur much later, in the fourth and fifth decades. HNPCC has been associated with germline mutations in mismatch repair (MMR) genes. It has been subdivided into Lynch syndrome I or site-specific colonic cancer, and LYNCH SYNDROME II which includes extracolonic cancer.
A condition characterized by poorly-circumscribed gelatinous masses filled with malignant mucin-secreting cells. Forty-five percent of pseudomyxomas arise from the ovary, usually in a mucinous cystadenocarcinoma (CYSTADENOCARCINOMA, MUCINOUS), which has prognostic significance. Pseudomyxoma peritonei must be differentiated from mucinous spillage into the peritoneum by a benign mucocele of the appendix. (Segen, Dictionary of Modern Medicine, 1992)
A malignant epithelial tumor of glandular tissue, especially the salivary glands, characterized by acini with mucus-producing cells and by the presence of malignant squamous elements. Most mucoepidermoid tumors are low-grade lesions readily cured by adequate excision. They may appear in any age group. They grow slowly. If high-grade, they behave aggressively, widely infiltrating the salivary gland and producing lymph node and distant metastases. (Dorland, 27th ed; from DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p575)
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