Michael: /* Subclassification */

2019-05-28T18:47:42Z

Subclassification

← Older revision		Revision as of 18:47, 28 May 2019
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	**Not associated with FAP.		**Not associated with FAP.
	*Gastric: foveolar epithelium.		*Gastric: foveolar epithelium.
	**Associated with [[familial adenomatous polyposis]] (FAP).		**Associated with [[familial adenomatous polyposis]] (FAP).<ref name=pmid24525509>{{Cite journal \| last1 = Wood \| first1 = LD. \| last2 = Salaria \| first2 = SN. \| last3 = Cruise \| first3 = MW. \| last4 = Giardiello \| first4 = FM. \| last5 = Montgomery \| first5 = EA. \| title = Upper GI tract lesions in familial adenomatous polyposis (FAP): enrichment of pyloric gland adenomas and other gastric and duodenal neoplasms. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 3 \| pages = 389-93 \| month = Mar \| year = 2014 \| doi = 10.1097/PAS.0000000000000146 \| PMID = 24525509 }}</ref>

	==Microscopic==		==Microscopic==

Michael at 18:39, 28 May 2019

2019-05-28T18:39:00Z

← Older revision		Revision as of 18:39, 28 May 2019
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	'''Stomach adenoma''', also '''gastric adenoma''', is a precursor to [[adenocarcinoma of the stomach]].		'''Stomach adenoma''', also '''gastric adenoma''', is a precursor to [[adenocarcinoma of the stomach]].

	''Gastric columnar dysplasia'', ''gastric dysplasia'' and ''tubular adenoma of the stomach'' direct here.		''Gastric columnar dysplasia'', ''gastric dysplasia'', and ''tubular adenoma of the stomach'' direct here.

	==General==		==General==

Michael at 18:37, 28 May 2019

2019-05-28T18:37:46Z

← Older revision		Revision as of 18:37, 28 May 2019
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	'''Stomach adenoma''', also '''gastric adenoma''', is a precursor to [[adenocarcinoma of the stomach]].		'''Stomach adenoma''', also '''gastric adenoma''', is a precursor to [[adenocarcinoma of the stomach]].

	''Gastric columnar dysplasia'' and ''tubular adenoma of the stomach'' direct here.		''Gastric columnar dysplasia'', ''gastric dysplasia'' and ''tubular adenoma of the stomach'' direct here.

	==General==		==General==

Michael at 18:36, 28 May 2019

2019-05-28T18:36:23Z

← Older revision		Revision as of 18:36, 28 May 2019
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	'''Stomach adenoma''', also '''gastric adenoma''', is a precursor to [[adenocarcinoma of the stomach]].		'''Stomach adenoma''', also '''gastric adenoma''', is a precursor to [[adenocarcinoma of the stomach]].

	''Gastric columnar dysplasia'' direct here.		''Gastric columnar dysplasia'' and ''tubular adenoma of the stomach'' direct here.

	==General==		==General==

Michael: tweak

2019-05-28T18:34:49Z

tweak

← Older revision		Revision as of 18:34, 28 May 2019
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	'''~~Dysplasia of stomach~~''' is a precursor to [[adenocarcinoma of the stomach]].		'''Stomach adenoma''', also '''gastric adenoma''', is a precursor to [[adenocarcinoma of the stomach]].

	:''Gastric ~~adenoma'' and ''gastric~~ columnar dysplasia'' direct here.		''Gastric columnar dysplasia'' direct here.

	==General==		==General==

Michael: split out of Stomach

2019-05-28T18:34:15Z

split out of Stomach

New page

'''Dysplasia of stomach''' is a precursor to [[adenocarcinoma of the stomach]].

:''Gastric adenoma'' and ''gastric columnar dysplasia'' direct here.

==General==
*Lesions that protrude into the lumen ''and'' are macroscopically apparent are known as: ''adenomas''.<ref name=pmid10680883>{{Cite journal | last1 = Rugge | first1 = M. | last2 = Correa | first2 = P. | last3 = Dixon | first3 = MF. | last4 = Hattori | first4 = T. | last5 = Leandro | first5 = G. | last6 = Lewin | first6 = K. | last7 = Riddell | first7 = RH. | last8 = Sipponen | first8 = P. | last9 = Watanabe | first9 = H. | title = Gastric dysplasia: the Padova international classification. | journal = Am J Surg Pathol | volume = 24 | issue = 2 | pages = 167-76 | month = Feb | year = 2000 | doi = | PMID = 10680883 }}</ref>
*Polypoid forms are grouped various ways.<ref name=pmid18384215>{{Cite journal | last1 = Park | first1 = do Y. | last2 = Lauwers | first2 = GY. | title = Gastric polyps: classification and management. | journal = Arch Pathol Lab Med | volume = 132 | issue = 4 | pages = 633-40 | month = Apr | year = 2008 | doi = 10.1043/1543-2165(2008)132[633:GPCAM]2.0.CO;2 | PMID = 18384215 | url=http://www.archivesofpathology.org/doi/full/10.1043/1543-2165(2008)132%5B633:GPCAM%5D2.0.CO;2 }}</ref>

===Grading===
Like in the colon - they are divided into:
*Low grade.
*High grade.

===Subclassification===
One subclassification:<ref>URL: [http://surgpathcriteria.stanford.edu/gitumors/gastric-adenoma/printable.html http://surgpathcriteria.stanford.edu/gitumors/gastric-adenoma/printable.html]. Accessed on: 18 December 2012.</ref>
*Intestinal: goblet cells or [[Paneth cell]]s.
**Not associated with FAP.
*Gastric: foveolar epithelium.
**Associated with [[familial adenomatous polyposis]] (FAP).

==Microscopic==
*Histologic criteria similar to columnar dysplasia in the [[esophagus]].
**The threshold is much lower than in the colon and rectum.

===Foveolar type===
Features:
*Hyperchromasia at the surface - '''key feature'''.
*Cytoplasm with (shortened) champagne flute-like luminal aspect (apical mucin caps).
*Nuclear changes:
**Hyperchromasia.
**Enlargement.
*No intestinal metaplasia.

DDx:
*[[Gastric carcinoma]].
*[[Reactive changes]].

===Intestinal type===
Features - intestinal:
*[[Intestinal metaplasia of the stomach|Intestinal metaplasia]].
*Hyperchromasia of cytoplasm.
*Nuclear changes:
**Loss of nuclear polarity.
**Increased [[NC ratio]].
**Elongation of nucleus and pseudostratification.

DDx:
*[[Gastric carcinoma]].
*[[Reactive changes]].
*[[Intestinal metaplasia of the stomach|Intestinal metaplasia]].

====Images====
<gallery>
Image:Gastric_adenoma_(1).jpg | Gastric adenoma. (WC/KGH)
Image:Gastric_adenoma_(2).jpg | Gastric adenoma. (WC/KGH)
</gallery>
www:
*[http://www.sciencedirect.com/science/article/pii/S1756231710001878 Gastric polyps - several images (sciencedirect.com)].
*[http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282008%29132%5B633%3AGPCAM%5D2.0.CO%3B2 Gastric polyps - several images (achivesofpathology.org)].

===Grading===
====Low-grade gastric dysplasia====
Features:
*Nuclear changes:
**Nuclear crowding/pseudostratification with hyperchromasia.
**Elongation of nuclei (cigar-shaped nuclei).
**Nuclear stratification intact; nuclei close to the basement membrane.
*Architecture:
**Focal irregularities in the glandular contours.

Negatives:
*No desmoplasia.
*No necrosis.
*No surface maturation.

DDx:
*Indefinite for dysplasia.
*High-grade gastric columnar dysplasia - see below.
**The threshold is much lower than in the colon and rectum!

Images:
*[http://path.upmc.edu/cases/case431.html Low-grade gastric columnar dysplasia - several images (upmc.edu)].
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204467/figure/F4/ Gastric low-grade dysplasia (nih.gov)].<ref name=pmid22076218>{{Cite journal | last1 = Kushima | first1 = R. | last2 = Kim | first2 = KM. | title = Interobserver Variation in the Diagnosis of Gastric Epithelial Dysplasia and Carcinoma between Two Pathologists in Japan and Korea. | journal = J Gastric Cancer | volume = 11 | issue = 3 | pages = 141-5 | month = Sep | year = 2011 | doi = 10.5230/jgc.2011.11.3.141 | PMID = 22076218 }}</ref>
====High-grade gastric dysplasia====
Features:
*Nuclear changes:
**Round hyperchromatic nuclei.
**Loss of normal nuclear stratification.
*Architecture:
**Irregularities in the glandular contours.
**Back-to-back glands.
**+/-Cribriforming of the glands.
**+/-Necrosis.

Negatives:
*No [[desmoplasia]].

DDx:
*Low-grade gastric columnar dysplasia.
*[[Gastric adenocarcinoma]].

====Images====
<gallery>
Image:High_grade_gastric_dysplasia_-_low_mag.jpg | High grade gastric dysplasia - low mag. (WC/Nephron)
Image:High_grade_gastric_dysplasia_-_very_high_mag.jpg | High grade gastric dysplasia - very high mag. (WC/Nephron)
</gallery>
www:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404600/figure/F8/ Gastric high-grade dysplasia - probably (nih.gov)].<ref name=pmid22188910>{{Cite journal | last1 = Correa | first1 = P. | last2 = Piazuelo | first2 = MB. | title = The gastric precancerous cascade. | journal = J Dig Dis | volume = 13 | issue = 1 | pages = 2-9 | month = Jan | year = 2012 | doi = 10.1111/j.1751-2980.2011.00550.x | PMID = 22188910 }}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204467/figure/F7/ Gastric high-grade dysplasia - probably (nih.gov)].
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204467/figure/F6/ Gastric high-grade dysplasia (nih.gov)].<ref name=pmid22076218/>

==Sign out==
===Indefinite for dypslasia===
<pre>
STOMACH, ANTRUM, BIOPSIES:
- ANTRAL-TYPE MUCOSA INDEFINITE FOR DYSPLASIA WITH MODERATE CHRONIC INFLAMMATION.
- EXTENSIVE INTESTINAL METAPLASIA.
- NEGATIVE FOR HELICOBACTER-LIKE ORGANSIMS.
- NEGATIVE FOR MALIGNANCY.
</pre>

===Intestinal type===
<pre>
STOMACH, ANTRUM, BIOPSIES:
- ANTRAL-TYPE MUCOSA WITH FOCUS OF LOW-GRADE DYSPLASIA (INTESTINAL TYPE).
- EXTENSIVE INTESTINAL METAPLASIA.
- MODERATE CHRONIC INFLAMMATION.
- NEGATIVE FOR HELICOBACTER-LIKE ORGANSIMS.
- NEGATIVE FOR MALIGNANCY.
</pre>

===Foveolar type===
<pre>
STOMACH POLYP, EXCISION:
- ADENOMATOUS POLYP, FOVEOLAR TYPE.
- NEGATIVE FOR HIGH-GRADE DYSPLASIA.
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS.
</pre>

===Foveolar type with high-grade dysplasia===
<pre>
STOMACH POLYP, EXCISION:
- LARGE ADENOMATOUS POLYP (FOVEOLAR TYPE) WITH HIGH-GRADE DYSPLASIA.
- NEGATIVE FOR MALIGNANCY.
</pre>

==See also==
*[[Stomach]].

==References==
{{Reflist|1}}

[[Category:Gastrointestinal pathology]]
[[Category:Diagnosis]]

Stomach adenoma - Revision history

Michael: /* Subclassification */

Michael at 18:39, 28 May 2019

Michael at 18:37, 28 May 2019

Michael at 18:36, 28 May 2019

Michael: tweak

Michael: split out of Stomach