Gastrointestinal Tract - Original Article

Gastric and small intestinal traditional serrated adenomas: a detailed morphologic and immunohistochemical analysis

Volume 31 · Issue 6 Publish Date: June 15, 2020
Saba Kiremitçi Cevriye Cansız Ersöz Berna Savaş Arzu Ensari
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Published In

Turkish Journal of Gastroenterology

Volume 31 · Issue 6

Pages: 441-450

History

Published Online: June 15, 2020

Copyright © 2020 Saba Kiremitçi, Cevriye Cansız Ersöz, Berna Savaş, Arzu Ensari

Saba Kiremitçi
Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
Cevriye Cansız Ersöz
Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
Berna Savaş
Departments of Pathology and Gastroenterology, Ankara University School of Medicine, Ankara
Arzu Ensari
Departments of Gastroenterology Pathology Ankara University
Kiremitçi, S., Ersöz, C. C., Savaş, B., & Ensari, A. (2020). Gastric and small intestinal traditional serrated adenomas: a detailed morphologic and immunohistochemical analysis. Turkish Journal of Gastroenterology, 31(6), 441–450. https://doi.org/10.5152/tjg.2020.19931
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Abstract

Background/Aims: TSAs, despite their low incidence in colorectum, may originate in other parts of gastrointestinal (GI) tract, including stomach and small intestine. Malignant transformation for upper GI TSAs has recently been reported in the literature. We, hereby, present a series of gastric and small intestinal TSAs with the aim to characterize their morphologic and immunophenotypic features as well as their neoplastic potential in a compartmental manner using digitalized images. Materials and Methods: The study comprised of 12 GI polyps with TSA features; 5 gastric and 7 small intestinal. Extent of characteristic features of TSA including eosinophilic cells, ectopic crypt foci (ECF), slit-like serration, foveolar epithelium, goblet cells, together with dysplastic/carcinomatous foci were assessed on digitalized H&E images and were used as reference for immunohistochemical analysis. Results: All polyps in the cohort contained eosinophilic cells as the most extensive morphologic feature followed by ECF and slit-like serration in decreasing order. Serrated dysplasia was more common in gastric polyps which more frequently showed neoplastic progression compared to intestinal ones. CK20 was the most widely expressed marker with a preference to eosinophilic cells while ECF were mostly negative. Ki67 showed the opposite pattern of CK20. MUC6 and MUC2 were selectively expressed in basal zone and goblet cells, respectively. Conclusion: Our results showed that presence of eosinophilic cells with pencillate nuclei commonly accompanied by ECF and slit-like serration are the defining features of gastric and small intestinal TSAs. They frequently harbour neoplastic foci, particularly in gastric location where serrated dysplasia seems to be more common.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 31 · Issue 6
Pages 441-450
DOI 10.5152/tjg.2020.19931
History
Published Online June 15, 2020
Copyright
Copyright (c) 2020 Saba Kiremitçi, Cevriye Cansız Ersöz, Berna Savaş, Arzu Ensari
Affiliations
Saba Kiremitçi
Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
Cevriye Cansız Ersöz
Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
Berna Savaş
Departments of Pathology and Gastroenterology, Ankara University School of Medicine, Ankara
Arzu Ensari
Departments of Gastroenterology Pathology Ankara University
Cite this Article
Kiremitçi, S., Ersöz, C. C., Savaş, B., & Ensari, A. (2020). Gastric and small intestinal traditional serrated adenomas: a detailed morphologic and immunohistochemical analysis. Turkish Journal of Gastroenterology, 31(6), 441–450. https://doi.org/10.5152/tjg.2020.19931
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