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Review
Evolving pathologic concepts of serrated lesions of the colorectum
Jung Ho Kim, Gyeong Hoon Kang
J Pathol Transl Med. 2020;54(4):276-289.   Published online June 26, 2020
DOI: https://doi.org/10.4132/jptm.2020.04.15
  • 9,940 View
  • 684 Download
  • 28 Web of Science
  • 23 Crossref
AbstractAbstract PDFSupplementary Material
Here, we provide an up-to-date review of the histopathology and molecular pathology of serrated colorectal lesions. First, we introduce the updated contents of the 2019 World Health Organization classification for serrated lesions. The sessile serrated lesion (SSL) is a new diagnostic terminology that replaces sessile serrated adenoma and sessile serrated polyp. The diagnostic criteria for SSL were revised to require only one unequivocal distorted serrated crypt, which is sufficient for diagnosis. Unclassified serrated adenomas have been included as a new category of serrated lesions. Second, we review ongoing issues concerning the morphology of serrated lesions. Minor morphologic variants with distinct molecular features were recently defined, including serrated tubulovillous adenoma, mucin-rich variant of traditional serrated adenoma (TSA), and superficially serrated adenoma. In addition to intestinal dysplasia and serrated dysplasia, minimal deviation dysplasia and not otherwise specified dysplasia were newly suggested as dysplasia subtypes of SSLs. Third, we summarize the molecular features of serrated lesions. The critical determinant of CpG island methylation development in SSLs is patient age. Interestingly, there may be ethnic differences in BRAF/KRAS mutation frequencies in SSLs. The molecular pathogenesis of TSAs is divided into KRAS and BRAF mutation pathways. SSLs with MLH1 methylation can progress into favorable prognostic microsatellite instability-positive (MSI+)/CpG island methylator phenotype-positive (CIMP+) carcinomas, whereas MLH1-unmethylated SSLs and BRAF-mutated TSAs can be precursors of poor-prognostic MSI−/CIMP+ carcinomas. Finally, based on our recent data, we propose an algorithm for stratifying risk subgroups of non-dysplastic SSLs.

Citations

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  • Impact of AI-aided colonoscopy in clinical practice: a prospective randomised controlled trial
    Johanna Schöler, Marko Alavanja, Thomas de Lange, Shunsuke Yamamoto, Per Hedenström, Jonas Varkey
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  • The histologic features, molecular features, detection and management of serrated polyps: a review
    Jin-Dong Wang, Guo-Shuai Xu, Xin-Long Hu, Wen-Qiang Li, Nan Yao, Fu-Zhou Han, Yin Zhang, Jun Qu
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Comparison of adenoma detection rate and proximal serrated polyp detection rate and their effect on post-colonoscopy colorectal cancer mortality in screening patients
    Jasmin Zessner-Spitzenberg, Elisabeth Waldmann, Lena Jiricka, Lisa-Maria Rockenbauer, Anna Hinterberger, Jeremy Cook, Arno Asaturi, Aleksandra Szymanska, Barbara Majcher, Michael Trauner, Monika Ferlitsch
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  • The yield of dysplasia and serrated lesions in a single-centre tertiary inflammatory bowel disease cohort
    Fiona Yeaman, Lena Thin
    Therapeutic Advances in Gastroenterology.2023; 16: 175628482311672.     CrossRef
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    Chiaki Inagaki, Ryo Matoba, Satoshi Yuki, Manabu Shiozawa, Akihito Tsuji, Eisuke Inoue, Kei Muro, Wataru Ichikawa, Masashi Fujii, Yu Sunakawa
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    JAMA.2023; 330(18): 1760.     CrossRef
  • Impact of comprehensive optical diagnosis training using Workgroup serrAted polypS and Polyposis classification on detection of adenoma and sessile serrated lesion
    Jooyoung Lee, Jung Ho Bae, Su Jin Chung, Hae Yeon Kang, Seung Joo Kang, Min‐Sun Kwak, Ji Yeon Seo, Ji Hyun Song, Sun Young Yang, Jong In Yang, Seon Hee Lim, Jeong Yoon Yim, Joo Hyun Lim, Goh Eun Chung, Eun Hyo Jin, Ji Min Choi, Yoo Min Han, Joo Sung Kim
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    Pathology International.2022; 72(2): 128.     CrossRef
  • Comprehensive clinicopathologic, molecular, and immunologic characterization of colorectal carcinomas with loss of three intestinal markers, CDX2, SATB2, and KRT20
    Ji Ae Lee, Mi-Kyoung Seo, Seung-Yeon Yoo, Nam-Yun Cho, Yoonjin Kwak, Kyoungbun Lee, Jung Ho Kim, Gyeong Hoon Kang
    Virchows Archiv.2022; 480(3): 543.     CrossRef
  • Serrated Colorectal Lesions: An Up-to-Date Review from Histological Pattern to Molecular Pathogenesis
    Martino Mezzapesa, Giuseppe Losurdo, Francesca Celiberto, Salvatore Rizzi, Antonio d’Amati, Domenico Piscitelli, Enzo Ierardi, Alfredo Di Leo
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  • Arterial stiffness is associated with high-risk colorectal adenomas and serrated lesions: A cross-sectional study in a Taiwanese population
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  • Morphological and molecular characterization of colorectal sessile serrated lesions with dysplasia
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  • Serrated polyposis: an overview
    Jonathan Fawkes
    Gastrointestinal Nursing.2022; 20(9): 24.     CrossRef
  • Sessile serrated lesion presenting as large pedunculated polyp in the rectum: A case report
    Shin Ju Oh, Jung-Wook Kim, Chi Hyuk Oh
    Medicine.2022; 101(51): e32287.     CrossRef
  • WHICH LESIONS ARE AT HIGHER RISK OF DEVELOPING COLORECTAL CARCINOMAS: SUPERFICIALLY ELEVATED SERRATED LESIONS OR DEPRESSED LESIONS?
    Artur Adolfo PARADA, Filadelfio Euclydes VENCO, Miguel Reynaldo VARCA-NETO, Roberto EL IBRAHIM, Paula Bechara POLETTI, Helcio Pedrosa BRITO, Heloisa de Fátima SARE, Osvaldo MALAFAIA
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  • Endoscopic diagnosis for colorectal sessile serrated lesions
    Toshihiro Nishizawa, Shuntaro Yoshida, Akira Toyoshima, Tomoharu Yamada, Yoshiki Sakaguchi, Taiga Irako, Hirotoshi Ebinuma, Takanori Kanai, Kazuhiko Koike, Osamu Toyoshima
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  • NTRK oncogenic fusions are exclusively associated with the serrated neoplasia pathway in the colorectum and begin to occur in sessile serrated lesions
    Jung Ho Kim, Jeong Hoon Hong, Yoon‐La Choi, Ji Ae Lee, Mi‐kyoung Seo, Mi‐Sook Lee, Sung Bin An, Min Jung Sung, Nam‐Yun Cho, Sung‐Su Kim, Young Kee Shin, Sangwoo Kim, Gyeong Hoon Kang
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  • Differential pre-malignant programs and microenvironment chart distinct paths to malignancy in human colorectal polyps
    Bob Chen, Cherie’ R. Scurrah, Eliot T. McKinley, Alan J. Simmons, Marisol A. Ramirez-Solano, Xiangzhu Zhu, Nicholas O. Markham, Cody N. Heiser, Paige N. Vega, Andrea Rolong, Hyeyon Kim, Quanhu Sheng, Julia L. Drewes, Yuan Zhou, Austin N. Southard-Smith, Y
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  • Molecular Insights Into Colorectal Carcinoma
    Domenika Ortiz Requena, Monica Garcia-Buitrago
    Archives of Medical Research.2020; 51(8): 839.     CrossRef
Case Report
Rectal Invasion by Prostatic Adenocarcinoma That Was Initially Diagnosed in a Rectal Polyp on Colonoscopy
Ghilsuk Yoon, Man-Hoon Han, An Na Seo
J Pathol Transl Med. 2019;53(4):266-269.   Published online April 11, 2019
DOI: https://doi.org/10.4132/jptm.2019.03.25
  • 5,735 View
  • 117 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Despite anatomical proximity, prostatic adenocarcinoma with rectal invasion is extremely rare. We present a case of rectal invasion by prostatic adenocarcinoma that was initially diagnosed from a rectal polyp biopsied on colonoscopy in a 69-year-old Korean man. He presented with dull anal pain and voiding discomfort for several days. Computed tomography revealed either prostatic adenocarcinoma with rectal invasion or rectal adenocarcinoma with prostatic invasion. His tumor marker profile showed normal prostate specific antigen (PSA) level and significantly elevated carcinoembryonic antigen level. Colonoscopy was performed, and a specimen was obtained from a round, 1.5 cm, sessile polyp that was 1.5 cm above the anal verge. Microscopically, glandular tumor structures infiltrated into the rectal mucosa and submucosa. Immunohistochemically, the tumor cells showed alpha-methylacyl-CoA-racemase positivity, PSA positivity, and caudal-related homeobox 2 negativity. The final diagnosis of the rectal polyp was consistent with prostatic adenocarcinoma. Here, we present a rare case that could have been misdiagnosed as rectal adenocarcinoma.

Citations

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  • An Interesting Case of Prostate Cancer Presenting With Colonic Metastasis
    Shawn Keating, Ayesha Imtiaz, Kenneth Nahum, Ankita Prasad, Pramil Cheriyath
    Cureus.2023;[Epub]     CrossRef
  • Metastase d’un adenocarcinome prostatique au sein d’un polype colique. À propos d’un cas et revue de la littérature
    Guillaume Abitbol, Clémence Barthomeuf, Olivier Varennes, Marine Clement, Sami Hakim, Denis Chatelain
    Annales de Pathologie.2023; 43(4): 342.     CrossRef
  • Prostate cancer invading rectal serosa and anal sphincter treated with definitive radiation therapy: Case report and review of the literature
    Mi-Jo Lee
    Journal of Cancer Research and Therapeutics.2023;[Epub]     CrossRef
  • Isolated Rectal Metastases from Locally Advanced Carcinoma Prostate Detected by 18F-PSMA-1007 PET/CT
    Shashank Shekhar Singh, Rani Kunti Randhir Singh, Narvesh Kumar, Harshvardhan Atrey
    World Journal of Nuclear Medicine.2022; 21(03): 248.     CrossRef
  • Rectal Invasion by Metastatic Prostate Adenocarcinoma
    Anshu Wadehra, Samer Alkassis, Aliza Rizwan, Omid Yazdanpanah
    Cureus.2021;[Epub]     CrossRef
  • Metastatic Prostate Cancer Presenting as a Rectal Polyp: A Rare Occurrence
    Ese Uwagbale, Ifeanyichukwu Onukogu, Vimal Bodiwala, Solomon Agbroko, Niket Sonpal
    Cureus.2021;[Epub]     CrossRef
  • Local Staging of Prostate Cancer with Multiparametric MRI
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Original Article
The Smad4/PTEN Expression Pattern Predicts Clinical Outcomes in Colorectal Adenocarcinoma
Yumin Chung, Young Chan Wi, Yeseul Kim, Seong Sik Bang, Jung-Ho Yang, Kiseok Jang, Kyueng-Whan Min, Seung Sam Paik
J Pathol Transl Med. 2018;52(1):37-44.   Published online October 23, 2017
DOI: https://doi.org/10.4132/jptm.2017.10.20
  • 10,329 View
  • 227 Download
  • 10 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Background
Smad4 and PTEN are prognostic indicators for various tumor types. Smad4 regulates tumor suppression, whereas PTEN inhibits cell proliferation. We analyzed and compared the performance of Smad4 and PTEN for predicting the prognosis of patients with colorectal adenocarcinoma.
Methods
Combined expression patterns based on Smad4+/– and PTEN+/– status were evaluated by immunostaining using a tissue microarray of colorectal adenocarcinoma. The relationships between the protein expression and clinicopathological variables were analyzed.
Results
Smad4–/PTEN– status was most frequently observed in metastatic adenocarcinoma, followed by primary adenocarcinoma and tubular adenoma (p<.001). When Smad4–/PTEN– and Smad4+/PTEN+ groups were compared, Smad4–/PTEN– status was associated with high N stage (p=.018) and defective mismatch repair proteins (p=.006). Significant differences in diseasefree survival and overall survival were observed among the three groups (Smad4+/PTEN+, Smad4–/PTEN+ or Smad4+/PTEN–, and Smad4–/PTEN–) (all p<.05).
Conclusions
Concurrent loss of Smad4 and PTEN may lead to more aggressive disease and poor prognosis in patients with colorectal adenocarcinoma compared to the loss of Smad4 or PTEN alone.

Citations

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  • The Potential Role of Genomic Signature in Stage II Relapsed Colorectal Cancer (CRC) Patients: A Mono-Institutional Study
    Michela Roberto, Giulia Arrivi, Emanuela Pilozzi, Andrea Montori, Genoveffa Balducci, Paolo Mercantini, Andrea Laghi, Debora Ierinò, Martina Panebianco, Daniele Marinelli, Silverio Tomao, Paolo Marchetti, Federica Mazzuca
    Cancer Management and Research.2022; Volume 14: 1353.     CrossRef
  • Alterations of PTEN and SMAD4 methylation in diagnosis of breast cancer: implications of methyl II PCR assay
    Menha Swellam, Entsar A. Saad, Shimaa Sabry, Adel Denewer, Camelia Abdel Malak, Amr Abouzid
    Journal of Genetic Engineering and Biotechnology.2021; 19(1): 54.     CrossRef
  • E3 ubiquitin ligase HECW1 promotes the metastasis of non-small cell lung cancer cells through mediating the ubiquitination of Smad4
    Chen Lu, Guangyao Ning, Panpan Si, Chunsheng Zhang, Wenjian Liu, Wei Ge, Kai Cui, Renquan Zhang, Shenglin Ge
    Biochemistry and Cell Biology.2021; 99(5): 675.     CrossRef
  • Computational quantification of global effects induced by mutations and drugs in signaling networks of colorectal cancer cells
    Sara Sommariva, Giacomo Caviglia, Silvia Ravera, Francesco Frassoni, Federico Benvenuto, Lorenzo Tortolina, Nicoletta Castagnino, Silvio Parodi, Michele Piana
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  • Clinicopathological characterization of SMAD4-mutated intestinal adenocarcinomas: A case-control study
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  • Reply to: Dissecting the therapeutic implications of the complex SMAD4 regulatory network in metastatic colorectal cancer
    Jordan M. Cloyd, Takashi Mizuno, Jean-Nicolas Vauthey
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Case Studies
A Case of Giant Colonic Muco-submucosal Elongated Polyps Associated with Intussusception
Joo Heon Kim, Seung Yun Lee, Je Ho Jang, Hyun Young Han, Dong Wook Kang
J Pathol Transl Med. 2016;50(6):474-478.   Published online May 23, 2016
DOI: https://doi.org/10.4132/jptm.2016.04.27
  • 8,106 View
  • 117 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Colonic muco-submucosal elongated polyp (CMSEP), a newly categorized non-neoplastic colorectal polyp, is a pedunculated and elongated polyp composed of normal mucosal and submucosal layers without any proper muscle layer. We herein report a giant variant of CMSEP associated with intussusception in the rectosigmoid colon, with a review of the literature. A 48-year-old woman underwent a laparoscopic low anterior resection due to multiple large submucosal polypoid masses associated with intussusception. Grossly, the colonic masses were multiple pedunculated polyps with a long stalk and branches ranging in size from a few millimeters to 14.0 cm in length. Microscopically, there was no evidence of hyperplasia, atypia, or active inflammation in the mucosa. The submucosal layers were composed of edematous and fibrotic stroma with fat tissue, dilated vessels, and lymphoid follicles.

Citations

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  • Multiple enteric muco-submucosal elongated polyps causing intussusception
    Atsuki Taniguchi, Izuru Endo, Takeyoshi Nishiyama, Nobuyuki Watanabe, Osamu Yoshida, Hiroaki Asano, Masatoshi Kubo, Tetsunobu Udaka
    Clinical Journal of Gastroenterology.2024; 17(1): 41.     CrossRef
  • Jejunal intussusception and perforation due to enteric muco-submucosal elongated polyp: a case report and literature review
    Ryosuke Kikuchi, Shigenobu Emoto, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shinya Abe, Hirofumi Sonoda, Aya Shinozaki-Ushiku, Soichiro Ishihara
    Surgical Case Reports.2023;[Epub]     CrossRef
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    Neil O’Morain, Ciaran McCloskey, Sinead Flanagan, Glen Doherty
    United European Gastroenterology Journal.2023; 11(4): 392.     CrossRef
  • Duodenal Worm-Like Polyp
    Pan Pan, Guoshan Zhang, Xiao Cui, Liang Liu
    Digestive Diseases and Sciences.2023; 68(12): 4275.     CrossRef
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    Xiaowen Fan, Melissa Hershman, Gabriel Levi, Ilan Weisberg
    ACG Case Reports Journal.2019; 6(6): e00110.     CrossRef
Follicular Dendritic Cell Sarcoma of the Inflammatory Pseudotumor-like Variant Presenting as a Colonic Polyp
Shien-Tung Pan, Chih-Yuan Cheng, Nie-Sue Lee, Peir-In Liang, Shih-Sung Chuang
Korean J Pathol. 2014;48(2):140-145.   Published online April 28, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.2.140
  • 8,646 View
  • 90 Download
  • 28 Crossref
AbstractAbstract PDF

Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.

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Primary Sigmoid Adenocarcinoma Metastasis to the Breast in a 28-Year-Old Female: A Case Study and a Review of Literature
Amna Ahmad, Kweku Baiden-Amissah, Adegoke Oyegade, Mohammed Absar, Kate Swainson, Sami Titi
Korean J Pathol. 2014;48(1):58-61.   Published online February 25, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.1.58
  • 7,318 View
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AbstractAbstract PDF

Metastasis to the breast from colorectal carcinoma is rare, only a few cases have been reported in the literature, and no cases have been reported in a young, 28-year-old patient. This report confirms the occurrence of the disease in a younger age group. The patient was referred to the Breast Clinic with a history of a gradually increasing lump in her right breast for two weeks' duration. On clinical examination, a 2-cm firm lump was noted in the upper inner quadrant of the right breast, which was clinically benign; however, histological examination of the breast core biopsy together with immunohistochemistry confirmed metastatic colorectal adenocarcinoma. The primary colorectal carcinoma was later confirmed to be a stage pT4N2M1 tumor, and the Duke stage was C1. Histology with immunohistochemistry is very important in the diagnosis of cases of this nature, but the clinical correlation should be taken into consideration at multidisciplinary team meetings to decide the final management of the patient.

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A Giant Peritoneal Loose Body
Hyun-Soo Kim, Ji-Youn Sung, Won Seo Park, Youn Wha Kim
Korean J Pathol. 2013;47(4):378-382.   Published online August 26, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.378
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AbstractAbstract PDF

Peritoneal loose bodies (PLBs) are usually discovered incidentally during laparotomy or autopsy. A few cases of giant PLBs presenting with various symptoms have been reported in the literature. Here, we describe a case of a giant PLB incidentally found in the pelvic cavity of a 50-year-old man. Computed tomography revealed a free ovoid mass in the pelvic cavity that consisted of central dense, heterogeneous calcifications and peripheral soft tissue. The mass was an egg-shaped, hard, glistening concretion measuring 7.5×7.0×6.8 cm and weighing 160 g. This concretion consisted of central necrotic fatty tissue surrounded by concentrically laminated, acellular, fibrous material. Small PLBs usually do not require any specific treatment. However, if PLBs cause alimentary or urinary symptoms due to their large size, surgical removal may be recommended. It is essential for clinicians to be aware of this entity and its characteristic features to establish the correct diagnosis.

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Rhabdoid Colorectal Carcinomas: Reports of Two Cases
Sang Hwa Lee, Hyesil Seol, Wook Youn Kim, So Dug Lim, Wan Seop Kim, Tae Sook Hwang, Hye Seung Han
Korean J Pathol. 2013;47(4):372-377.   Published online August 26, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.372
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AbstractAbstract PDF

Rhabdoid colorectal carcinomas are very rare and only 10 cases have been previously reported. We report two cases of rhabdoid colorectal carcinoma, one arising in the sigmoid colon of a 62-year-old man and another in the rectum of an 83-year-old woman. In both cases, the patients had advanced tumors with lymph node metastases. The tumors mostly showed a diffuse arrangement with rhabdoid features and small glandular regions were combined. Transitional areas from the adenocarcinomas to the rhabdoid tumors were also noted. Adenocarcinoma cells were positive for mixed cytokeratin (CK), CK20 and epithelial membranous antigen (EMA), but focal positive for vimentin. The rhabdoid tumor cells were positive for mixed CK, but focal positive or negative for CK20 and EMA. In addition, they were diffusely positive for vimentin, but negative for desmin. The histological and immunohistologial findings of these two cases suggest that the rhabodid tumor cells originated from dedifferentiated adenocarcinomas.

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Original Article
SIRT1 Expression Is Associated with Good Prognosis in Colorectal Cancer
Wonkyung Jung, Kwang Dae Hong, Woon Yong Jung, Eunjung Lee, Bong Kyung Shin, Han Kyeom Kim, Aeree Kim, Baek-hui Kim
Korean J Pathol. 2013;47(4):332-339.   Published online August 26, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.332
  • 9,594 View
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AbstractAbstract PDF
Background

Silent mating type information regulation 2 homolog 1 (SIRT1), an NAD+-dependent deacetylase, might act as a tumor promoter by inhibiting p53, but may also as a tumor suppressor by inhibiting several oncogenes such as β-catenin and survivin. Deleted in breast cancer 1 (DBC1) is known as a negative regulator of SIRT1.

Methods

Immunohistochemical expressions of SIRT1, DBC1, β-catenin, surviving, and p53 were evaluated using 2 mm tumor cores from 349 colorectal cancer patients for tissue microarray.

Results

Overexpression of SIRT1, DBC1, survivin, and p53 was seen in 235 (67%), 183 (52%), 193 (55%), and 190 (54%) patients, respectively. Altered expression of β-catenin was identified in 246 (70%) patients. On univariate analysis, overexpression of SIRT1 (p=0.029) and altered expression of β-catenin (p=0.008) were significantly associated with longer overall survival. Expression of SIRT1 was significantly related to DBC1 (p=0.001), β-catenin (p=0.001), and survivin (p=0.002), but not with p53. On multivariate analysis, age, tumor stage, differentiation, and expression of SIRT1 were independent prognostic factors significantly associated with overall survival.

Conclusions

SIRT1 overexpression is a good prognostic factor for colorectal cancer, and SIRT1 may interact with β-catenin and survivin rather than p53.

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    Jae Hyun Kim, Pyoung Rak Choi, Seun Ja Park, Moo In Park, Won Moon, Sung Eun Kim, Gyu Won Lee
    The Korean Journal of Gastroenterology.2014; 63(4): 209.     CrossRef
  • Down-Regulation of mir-221 and mir-222 Restrain Prostate Cancer Cell Proliferation and Migration That Is Partly Mediated by Activation of SIRT1
    Xiao Yang, Yingmei Yang, Rong Gan, Lingxu Zhao, Wei Li, Huaibin Zhou, Xiaojuan Wang, Jianxin Lu, Qing H. Meng, George Calin
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Case Studies
Colonic Adenocarcinoma Arising from Gastric Heterotopia: A Case Study
Hyoungsuk Ko, Shin Young Park, Eun Jung Cha, Jang Sihn Sohn
Korean J Pathol. 2013;47(3):289-292.   Published online June 25, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.289
  • 6,741 View
  • 41 Download
  • 16 Crossref
AbstractAbstract PDF

Heterotopic gastric mucosa occurs in all areas of the gastrointestinal tract including the nasopharynx, tongue, esophagus, small intestine, colon, and rectum. Gastric heterotopia of the large bowel is infrequent, and most cases have been reported in the rectum. Review of the literature has revealed only eight cases involving the colon proximal to the rectum. Little is known of the natural history of gastric heterotopias, except that. It usually presents with gastrointestinal bleeding, though other serious complications such as bowel perforation, intussusceptions, and fistula formation, are possible. Further, it is unclear whether heterotopic gastric mucosa progresses to malignancy. Herein, we describe a case of adenocarcinoma of the transverse colon arising from gastric heterotopia. To the best of our knowledge, this is the first report of adenocarcinoma arising from heterotopic gastric mucosa in the colon.

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    Sho Fujiwara, Ryuichi Nishimura, Nozomi Koyamada
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    Asher Lippe, Scott Lippe
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    Eduardo Dantas, Diva Yamaguti, Kendi Yamazaki
    Gastroenterología y Hepatología.2021; 44(8): 579.     CrossRef
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    Hyun-Il Seo, Jae-Young Kwak
    Advances in Pediatric Surgery.2021; 27(1): 32.     CrossRef
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    Eduardo Dantas, Diva Yamaguti, Kendi Yamazaki
    Gastroenterología y Hepatología (English Edition).2021; 44(8): 579.     CrossRef
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    Marcela Adriana Duran Alvarez, Carla Noemi Tafur Sanchez
    GE - Portuguese Journal of Gastroenterology.2020; 27(1): 65.     CrossRef
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    Caroline Bsirini, Pratyusha Tirumanisetty, Joseph N. Dytoc, Diana Agostini-Vulaj, Christopher Steevens, Asad Ullah, Aaron R. Huber
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    Journal of Surgical Case Reports.2019;[Epub]     CrossRef
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    Head & Neck.2018;[Epub]     CrossRef
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    Abul A S R Mannan, Michael Vieth, Armen Khararjian, Binny Khandakar, Dora Lam‐Himlin, David Heydt, Feriyl Bhaijee, Henry J Venbrux, Kathleen Byrnes, Lysandra Voltaggio, Norman Barker, Songyang Yuan, Elizabeth A Montgomery
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    Wen-Guo Chen, Hua-Tuo Zhu, Ming Yang, Guo-Qiang Xu, Li-Hua Chen, Hong-Tan Chen
    World Journal of Gastroenterology.2018; 24(30): 3462.     CrossRef
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    George A. Salem, Javid Fazili, Tauseef Ali
    Arab Journal of Gastroenterology.2017; 18(1): 42.     CrossRef
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    Peyman Dinarvand, Ashley A. Vareedayah, Nancy J Phillips, Christine Hachem, Jinping Lai
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Extrapelvic Uterus-like Masses Presenting as Colonic Submucosal Tumor: A Case Study and Review of Literature
Ki Yong Na, Gou Young Kim, Kyu Yeoun Won, Hyun-Soo Kim, Sang Won Kim, Chi Hoon Lee, Jae Myung Cha
Korean J Pathol. 2013;47(2):177-181.   Published online April 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.177
  • 7,796 View
  • 59 Download
  • 14 Crossref
AbstractAbstract PDF

A uterus-like mass (ULM) is a central cavity lined by endometrial glands and stroma and surrounded by thick-walled smooth muscles. To date, 31 cases of ULM have been reported in the English literature. ULM typically presents as a single mass and is located in the pelvic cavity. We report here a very rare case of multiple extrapelvic ULMs involving the cecum, descending colon, and mesocolon. After extensive literature research, our case appears to be the first case of multiple ULMs found in extrapelvic sites and the first case of ULM in the colon. The present case suggests that ULM should be included in the differential diagnosis of colonic submucosal tumors in female patients with chronic abdominal pain or menstruation-associated symptoms.

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    Matteo Giorgi, Luca Labanca, Gabriele Centini, Lucia Lazzeri, Francesco Giuseppe Martire, Ester Sorrentino, Virginia Mancini, Diego Raimondo, Antonio Raffone, Daniele Neola, Anna Chiara Aru, Nassir Habib, Paolo Casadio, Renato Seracchioli, Errico Zupi
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    Pooya Iranpour, Sara Haseli, Pedram Keshavarz, Amirreza Dehghanian, Neda Khalili, Michael S. Firstenberg
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Silent Colonic Malakoplakia in a Living-Donor Kidney Transplant Recipient Diagnosed during Annual Medical Examination
Go Eun Bae, Nara Yoon, Ha Young Park, Sang Yun Ha, Junhun Cho, Yunkyung Lee, Kyoung-Mee Kim, Cheol Keun Park
Korean J Pathol. 2013;47(2):163-166.   Published online April 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.163
  • 6,209 View
  • 56 Download
  • 8 Crossref
AbstractAbstract PDF

Malakoplakia is a characteristic inflammatory condition, which is usually seen in the urogenital tract, and less frequently in the gastrointestinal tract. We present a case of colonic malakoplakia in an immunocompromised patient. A 55-year-old female visited the outpatient clinic for routine cancer surveillance. Her past medical history was significant for kidney transplantation 11 years ago, and she had been taking immunosuppressants. A colonoscopy revealed several depressed flat lesions and elevated polyps, which were 0.3 to 0.4 cm in size and accompanied by whitish exudates. A biopsy revealed an infiltration of histiocytes with ample granular eosinophilic cytoplasm, with some lymphocytes and plasma cells. Many histiocytes had the characteristic morphology, described as Michaelis-Gutmann bodies: one or several round basophilic structures of approximately 1 to 10 µm in size with some being laminated, some appearing homogeneous, and others having a dense central core with a targetoid appearance. These Michaelis-Gutmann bodies were positively stained on von Kossa stain, and were diagnostic for malakoplakia.

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    Andrew Mitchell, Alexandre Dugas
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    Rana Ajabnoor, Mohammad Mawardi, Abdulmonem Almutawa
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Case Reports
Strongyloidiasis of Gastric and Colonic Mucosa in a Patient with Monoclonal Gammopathy of Undetermined Significance: A Case Report.
Jung Uee Lee, Sang Bum Kang, Hae Joung Sul, Jong Ok Kim
Korean J Pathol. 2011;45:S75-S78.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S75
  • 2,694 View
  • 15 Download
  • 1 Crossref
AbstractAbstract PDF
Here we report a case of Strongyloides stercoralis infection of the gastric and pancolonic mucosa in a 79-year-old female with a monoclonal gammopathy of undetermined significance. Endoscopic biopsies were performed in gastric antrum, cecum, distal ascending colon, and hepatic flexure of the colon. On microscopic examination, there were many adult worms, larvae and eggs in the gastric and colonic mucosa. Worms, larvae, and eggs were located in the crypts and within the lumen of the crypts. The body wall of the adult worm was composed of cuticle and a weak muscle layer. A routine stool examination failed to detect larvae or ova. Based on the histopathologic examination, these parasites were confirmed as S. stercoralis.

Citations

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  • Is Gastric Involvement by Strongyloides stercoralis in an Immunocompetent Patient a Common Finding? A Case Report and Review of the Literature
    Irene Pecorella, Tom Richard Okello, Gaia Ciardi, David Martin Ogwang
    Acta Parasitologica.2022; 67(1): 94.     CrossRef
A Metastatic Granulocyte Colony-Stimulating Factor Producing Sarcomatoid Carcinoma of the Lung Causing Jejunal Intussusception: Report of a Case.
Min Eui Hong, Soon Auck Hong, Gui Young Kwon, Tae Jin Lee, Eon Sub Park, Sung Jae Cha, Jae Hyuk Do, Jae Hyung Yoo
Korean J Pathol. 2011;45(2):205-208.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.205
  • 2,694 View
  • 20 Download
AbstractAbstract PDF
A 75-year-old man was referred to our hospital with intestinal obstruction caused by intussusception. Abdominal computed tomography (CT) revealed seven polypoid masses in the small intestine, while chest CT revealed a mass in the right lower lobe. Preoperative laboratory tests showed white blood cell (WBC) and neutrophil differential counts of 63,630/mm3 and 95%, respectively. The serum granulocyte colony-stimulating factor (G-CSF) was 114 pg/mL, which was elevated (normal range, <18.1 pg/mL). After resection of the small bowel, the WBC count decreased to 20,510/mm3. The pathology showed a poorly differentiated carcinoma with sarcomatous components confirmed by positive immunostaining of cytokeratin (AE1/AE3) and vimentin in the small intestine. Furthermore, immunohistochemistry with specific monoclonal antibodies against G-CSF was positive. A lung biopsy revealed the same histological findings as the small intestine lesion. Therefore, the patient was diagnosed as having a G-CSF producing sarcomatoid carcinoma of the lung with metastasis to the small intestine.
Original Article
Lethal Giant Larvae2 Expression Is Reduced or Localized at Cytoplasm in Colon Adenomas and Adenocarcinomas.
Tae Jung Jang
Korean J Pathol. 2010;44(5):488-492.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.488
  • 2,745 View
  • 14 Download
AbstractAbstract PDF
BACKGROUND
The Scribble, Par and Crumbs polarity modules are essential for establishing and maintaining apicobasal cell polarity in epithelial cells. The aim of the present study was to investigate the expression pattern of Lethal giant larvae2 (Lgl2) in normal colonic epithelium and epithelial tumors and to examine the relationship between Lgl2 expression and clinicopathological parameters.
METHODS
We examined Lgl2 expression in 66 primary colon cancers and 20 adenomas by immunohistochemistry.
RESULTS
In normal colonic epithelium, Lgl2 was strongly expressed at the basolateral membrane of cells in the luminal surface but was not expressed at the base of crypts. The expression pattern of E-cadherin in normal epithelium was similar to that of Lgl2. In contrast, tumors did not express Lgl2 or showed diffuse cytoplasmic staining. The Lgl2 positive rate in tumors was significantly lower than in normal epithelium, and its negative rate in tumors was higher in tumors with abnormal E-cadherin expression than in tumors with positive membranous staining. Lgl2 staining intensity was significantly lower in tumor budding sites than in tumor centers. No significant differences were observed between Lgl2 and clinicopathological parameters.
CONCLUSIONS
Lgl2 expression was reduced or localized at the cytoplasm in colon epithelial tumors, suggesting that a perturbation of Lgl2 expression frequently occurs in colon epithelial tumors.

J Pathol Transl Med : Journal of Pathology and Translational Medicine