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2017 ; 12
(1
): 1-8
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Malignant Colorectal Polyps; Pathological Consideration (A review)
#MMPMID29760747
Geramizadeh B
; Marzban M
; Owen DA
Iran J Pathol
2017[Win]; 12
(1
): 1-8
PMID29760747
show ga
BACKGROUND: Routine screening colonoscopy is on the rise and pathologists have to
deal with the ever larger numbers of excised colonic polyps. It is very important
to optimize the patients' individual treatment and further surveillance.
Pathologists play a critical role in management, as most of the clinical
decisions concerning colonic polyp management are based on pathologic findings.
One of the most important clinical issues in colonic adenomas is the diagnosis of
malignancy and reporting its different aspects by the pathologist. The histologic
type and the extent of carcinoma within a malignant polyp have considerable
impact on the decisions of gastroenterologists and surgeons for further
management. Therefore, the most recent literature regarding the diagnosis and
reporting of the different features of malignant polyps was reviewed. DATA
ACQUISITION: There is growing literature regarding the different pathologic
features and reporting of malignant colonic polyps, and in this review, published
articles that are listed on Google Scholar and Pub Med are discussed. CONCLUSION:
Diagnosis of malignant colon polyp requires the presence of tumor cells that are
penetrating beyond the muscular mucosa into submucosa (pT1). As well as
establishing a diagnosis of malignant polyp, it is very important to report the
size of the invasive component, the presence or absence of lymphovascular
invasion, the degree of tumor differentiation and the distance of the carcinoma
from the line of resection. Other important features that may be reported
include: the presence or absence of tumor budding, the depth of tumor cell
penetration into the submucosa, and results of immunohistochemistry for mismatch
repair proteins and BRAF.