A rare practice case — a diminutive sessile serrated adenoma of the colon
https://doi.org/10.31146/1682-8658-ecg-169-9-93-96
Abstract
Aim. An illustration of a case of diminutive sessile serrated adenoma (SSA) as a variant of the development of the normal colon mucosa.
Materials and methods. In 2017 a diminutive SSA was identified in the case of a 77 year-old patient. During endoscopic examination, which included white light endoscopy examination, narrow band imaging (NBI) and near focus, the main endoscopic signs of SSA were determined. Endoscopic removal of the lesion with subsequent confirmation of its histological structure was performed.
Results. The colonoscopy revealed a diminutive SSA of up to 3mm in size with typical endoscopic signs: a flat-elevated type 0-IIA, a “mucinous cap”, the same color to the surrounding mucosa, pit pattern type II-О, absence of meshed capillary vessels, but with isolated dilated capillaries. Histological examination revealed the crypts to have a cytoplasmic-type serration, drop-like expansion and horizontal growth of the basal parts, without epithelial dysplasia.
Conclusion. The presented clinical case shows a rare observation of a diminutive SSA, and the complexity of endoscopic diagnosis due to its small size. The above observation demonstrates one of the pathways — developing directly from the normal mucosa, bypassing the stage of hyperplastic polyp. Thus indicating the need for further study of serrated polyps, morphogenesis mechanisms and precancerous potential.
About the Authors
N. V. Ageykina
Medsi Clinic
Russian Federation
Natalya V. Ageykina, MD, PhD, Head of the Department of Endoscopy, Moscow, Russia
Russian Federation
Natalya V. Ageykina, MD, PhD, Head of the Department of Endoscopy, Moscow, Russia
E. D. Fedorov
Lomonosov Moscow State University; Pirogov Russian National Research Medical University
Russian Federation
Evgeni D. Fedorov, MD, ScD, Сhief Researcher, Moscow, Russia
Russian Federation
Evgeni D. Fedorov, MD, ScD, Сhief Researcher, Moscow, Russia
N. A. Oleynikova
Lomonosov Moscow State University
Russian Federation
Nina A. Oleynikova, MD, PhD, Researcher scientist, Department of Pathology, Moscow, Russia
Russian Federation
Nina A. Oleynikova, MD, PhD, Researcher scientist, Department of Pathology, Moscow, Russia
O. A. Kharlova
Lomonosov Moscow State University
Russian Federation
Olga A. Kharlova, MD, PhD, junior Researcher scientist, Department of Pathology, Moscow, Russia
Russian Federation
Olga A. Kharlova, MD, PhD, junior Researcher scientist, Department of Pathology, Moscow, Russia
N. V. Danilova
Lomonosov Moscow State University
Russian Federation
Natalya V. Danilova, MD, PhD, Senior researcher scientist, Department of Pathology, Moscow, Russia
Russian Federation
Natalya V. Danilova, MD, PhD, Senior researcher scientist, Department of Pathology, Moscow, Russia
P. G. Malkov
Medsi Clinic
Russian Federation
Pavel G. Malkov, MD, ScD, Head of Department of Pathology, Moscow, Russia
Russian Federation
Pavel G. Malkov, MD, ScD, Head of Department of Pathology, Moscow, Russia
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For citations:
Ageykina N.V., Fedorov E.D., Oleynikova N.A., Kharlova O.A., Danilova N.V., Malkov P.G. A rare practice case — a diminutive sessile serrated adenoma of the colon. Experimental and Clinical Gastroenterology. 2019;(9):93-96. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-169-9-93-96
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