INTESTINE Vol.24 No.4(6)

Series
Title A case of SSA/P (sessile serrated adenoma/polyp) with cytological dysplasia showing changes in endoscopic images over time
Publish Date 2020/11
Author Bunichiro Kato 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 Tamotsu Sugai Department of Molecular Diagnostic Pathology, Iwate Medical University, School of Medicine
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 ] A woman in her 70s underwent lower gastrointestinal endoscopy in 2006, which revealed a flat elevated lesion (6 mm in diameter) with mucous caps at the hepatic flexure, and the patient was followed-up. Endoscopy performed in 2009 revealed a slightly elongated and enlarged glandular orifice on the left side of the lesion. This lesion appeared as a protruding mass (6 mm in diameter) on endoscopy performed in 2011. Magnifying endoscopy revealed a type II-open pit pattern on the right side of the mass and a type VI pit pattern extending from its apex to the left side. The endoscopic diagnosis was adenocarcinoma with sessile serrated adenoma/polyp (SSA/P) with depth of invasion classified as cTis. Endoscopic mucosal resection was performed, and histopathological examination of the resected specimen confirmed the diagnosis of SSA/P with cytological dysplasia. This case report would significantly contribute to the literature because we have presented the findings of close follow-up showing changes in endoscopic images over time in addition to the results of molecular biological analysis.
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