Comparative Pathology — Human Large Intestinal Cancer And Animal Models
Herman Autrup, Gary M. Williams in Experimental Colon Carcinogenesis, 2019
Also called villous adenoma, villous polyps are less common than the adenomatous polyps and have distinctly different morphological as well as biological features. These are most often sessile lesions with broad base. Unlike the adenomatous polyps, the entire polyp is neoplastic. The polyp appears as if it has been plastered on to the mucosa. The surface of the polyp is characterized by finger-shaped structures reminiscent of the villi in the small intestine and, hence, the name villous polyps. Generally the morphological features of malignancy are more predominant throughout the entire polyp than that seen in adenomatous polyps. Villous polyps are also generally larger than the adenomatous polyps and the potential to progress to carcinomas is likewise much higher than any other polyps described earlier.5
Benign Neoplasms of the Colon and Rectum
Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens in Neoplasms of the Colon, Rectum, and Anus, 2007
Adenomas of the large bowel are usually asymptomatic and are frequently discovered during routine radiologic studies or endoscopic examinations. Bleeding per rectum is the most common finding if the polyp is situated in the rectum or sigmoid colon. A large pedunculated polyp in the lower part of the rectum may prolapse through the anus. A large villous adenoma may manifest as watery diarrhea; in rare instances it causes fluid and electrolyte imbalance. Intermittent abdominal pain from recurrent intussusception or spasm may occur with a large colonic polyp but is unusual. Mild anemia may follow chronic bleeding from an ulcerative polyp. With a small polyp, up to 8 mm, biopsy and electrocoagulation can be performed, preferably using a “hot” biopsy forceps for histopathologic examination. A large polyp should be completely snared or excised and sent for histopathologic examination. A biopsy of a large polyp does not represent the entire lesion and presents difficulty in the interpretation of an invasive carcinoma. Occasionally, biopsy may cause displacement of the gland into the submucosa and can be misinterpreted as an invasive carcinoma (27). This pseudoadenomatous invasion can also be caused by trauma from hard feces, repeated twisting of the stalk with subsequent ulceration of the surface (28).
Gastrointestinal Tract
Joseph Kovi, Hung Dinh Duong in Frozen Section In Surgical Pathology: An Atlas, 2019
DIFFERENTIAL DIAGNOSIS: ClinicalMalignant transformation of villous adenoma is common. In a mixed, villous, and adenomatous polyp malignant change is proportional to the amount of the villous component.187 Malignant transformation in an adenomatous polyp is relatively infrequent, about 5%. Malignant transformation in villous adenoma is frequent, 29 to 70%.181 The diagnosis can be made by digital examination of the rectum, proctosigmoidoscopy and barium enema. A soft velvety tumor with no apparent ulceration, or with no areas of firmness is most likely benign. Finding firm areas within the lesion and ulceration suggest carcinoma.191Gross AnatomicalVillous adenoma is generally a soft, velvety, and sessile lesion. Multiple biopsies are required to rule out malignant change. MicroscopicA frozen section diagnosis of benign villous adenoma or mixed villous and adenomatous polyp does not rule out the possibility that carcinoma will be found at the meticulous histologic examination of the fixed specimen.
Villous adenoma of the urethra
Published in Baylor University Medical Center Proceedings, 2021
Katherine E. Dowd, Derek Yang, Harry Papaconstantinou, Erin T. Bird
Villous adenoma is commonly encountered in the colorectal practice but is rarely seen by the urologic surgeon. Fibroepithelial urethral polyps are more readily seen by the urologist; they are generally benign and can be treated with local resection/ablation to resolve irritative voiding symptoms. Other encountered benign urethral lesions include hemangiomas, leiomyomas, urethral diverticulum, and cowpers gland or skenes gland duct cysts. Due to the variability of presentation of suspicious lesions, most urologists opt for biopsy at the time of resection or fulguration to rule out underlying malignancy. Villous adenomas of the genitourinary tract have been reported, but generally in small case series or reviews of case reports.1 They present similarly to other urethral lesions—with gross hematuria, dysuria, or irritative voiding symptoms—and a histopathologic diagnosis is usually needed.1 Because reports of association with adenocarcinoma exist, most authors recommend full resection of the lesion and consideration of magnetic resonance imaging (MRI) and colonoscopy to rule out coexisting adenocarcinoma or malignancy.2 The tumor is more commonly encountered at the bladder dome, trigone, and urachus if present.3
Serum macrophage inhibitory cytokine-1 serves as a novel diagnostic biomarker of early-stage colorectal cancer
Published in Biomarkers, 2021
Chunyang Dai, Xiaolei Zhang, Yanling Ma, Zhaowu Chen, Shaohua Chen, Yang Zhang, Ming Li
This study was based on the Colorectal Cancer Early Diagnosis and Treatment Project conducted in Hefei City, Anhui Province. We selected information from the Urban Society’s questionnaire given to asymptomatic normal persons from January 2014 to May 2016. The selection criteria were as follows: (1) age, 40–75 years, permanent resident of Hefei City; (2) cognitively proficient; (3) no serious heart, brain, lung, or kidney function conditions or mental illness; (4) compliance with the study protocol, voluntary participation, and signed informed consent agreement. Subjects’ characteristics analyzed included age, sex, body mass index (BMI), smoking status, and family history of tumours. Among 2759 patients who underwent colorectal endoscopy, 19 were diagnosed with invasive CRC, and 47 were diagnosed with the precancerous lesions as follows: (a) high-grade glandular intraepithelial neoplasia; (b) villous adenoma; (c) tubular adenoma; (d) multiple polyps (n > 10); or adenomatous polyps (≥1 cm diameter).
Solitary prostate cancer liver metastasis: an exceptional indication for liver resection
Published in Acta Chirurgica Belgica, 2021
Gilles Tilmans, Julie Navez, Mina Komuta, Thibaud Saussez, Jan Lerut
A 67-year old man underwent prostatectomy for prostate adenocarcinoma (PC) (Gleason unspecified, probably high risk PC) in 2004. His medical history included arterial hypertension and insulin independent diabetes mellitus. During follow-up determination of prostate specific antigen (PSA) and imaging were done regular. Eight years later a local (Gleason 8) recurrence was treated by radiotherapy and chemical castration using the luteinizing hormone-releasing hormone analogue (LHRH), gosereline acetate, (Zoladex®, AstraZeneca, Cambridge UK). Eighteen months later PSA level had increased from 0.04 to 32 ng/ml (nrl.value <0.04 ng/ml). PET-CT scan showed a hyper-metabolic lesion in both right colon and left liver. As the colonoscopy revealed a degenerated tubulo-villous adenoma the diagnosis of a metastazised colonic cancer was retained and a right hemicolectomy and liver biopsy were planned.
Related Knowledge Centers
- Colorectal Cancer
- Colorectal Polyp
- Epithelium
- Hypokalemia
- Cancer
- Malignancy
- Large Intestine
- Hyperplastic Polyp
- Adenoma
- Micrograph