INTESTINE Vol.22 No.5(10-1)

Theme Molecular biology of colorectal tumors
Title Case of SSA/P with cytological dysplasia
Publish Date 2018/09
Author Bunichiro Kato Department of Digestive Disease Center, Akita Red Cross Hospital
Author Eiji Harada Department of Digestive Disease Center, Akita Red Cross Hospital
Author Hiro-o Matsushita Department of Digestive Disease Center, Akita Red Cross Hospital
Author Kenjiro Yoshikawa Department of Digestive Disease Center, Akita Red Cross Hospital
Author Yoshihito Tanaka Department of Digestive Disease Center, Akita Red Cross Hospital / Department of Molecular Diagnostic Pathology, Iwate Medical University, School of Medicine
Author Hiro-o Yamano Department of Digestive Disease Center, Akita Red Cross Hospital / Department of Gastroenterology, Sapporo Medical University Hospital
Author Takuo Tokairin Department of Diagnostic Pathology, Akita Red Cross Hospital
Author Katsuhiko Enomoto Department of Diagnostic Pathology, Akita Red Cross Hospital
Author Eiichiro Yamamoto Department of Molecular Biology, Sapporo Medical University
Author Hiromu Suzuki Department of Molecular Biology, Sapporo Medical University
[ Summary ] We report on a case concerning a sessile serrated adenoma/polyp (SSA/P) with cytological dysplasia. The patient was a 70-year-old woman. She had a type Ⅱa lesion (5 mm in diameter) in the transverse colon. The lesion was covered with a mucosal cap. The upper portion of the lesion had protruded. Magnifying endoscopy indicated a Type Ⅱ-open pit pattern in the central and lower part ("barnacle like sign") of the lesion. Type Ⅳ pit patterns were observed in the upper part of the lesion. From these findings, we diagnosed this lesion to be SSA/P with cytological dysplasia. The histopathological diagnosis was 'SSA/P with cytological dysplasia'. We recognized a BRAF mutation in SSA/P and cytological dysplasia areas. We identified a CpG island methylator phenotype in SSA/P and cytological dysplasia areas, but methylation of hMLH1 was found only in the cytological dysplasia area.
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