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(TSA)的病变细胞核位于中央,细长,呈青霉状,染色质(a)分散
与正常小肠黏膜相似的上皮细胞狭窄缝(“缝隙样锯齿”)可能是 TSA (b)最特异的特征
C 异位隐窝灶(ECF)是指隐窝发育异常,并失去对粘膜肌层的定位
D“富含黏液蛋白的TSA”具有50%或以上的杯状/富含黏液蛋白的细胞,杯状细胞嗜酸性,吸收细胞比例至少为1:1
Tsa 上皮内淋巴细胞(箭头)数量相对增加
许多 TSAs (黑圈)包含邻近区域的增生性息肉或无柄锯齿状腺瘤(SSA)(红圈) ,这些后者被认为代表前体息肉(f)。
Serrated polyp of the colon and rectum with generalized cytologic dysplasia
Serrated adenoma
Serrated adenoma type II
Sessile serrated adenoma / polyp
Prominent serration of glands
Usually columnar cells with mucin depleted eosinophilic cytoplasm
Cytologic low grade dysplasia throughout
Hyperchromatic elongate nuclei
Frequent nuclear stratification
Complex architecture
Ectopic crypt formation
Short, crypts oriented at right angles ot main crypt
Unlike normal crypts they do not reach to muscularis mucosae
Multiple adjacent crypts contribute to serrated appearance
In SSA and HP, serrations are predominantly formed by apical cytoplasm
Filiform variant with long thin surface projections
Complex villi with serrated surface
Frequent stromal edema producing bulbous ends
Lined by tall non-mucinous eosinophilic cytoplasm
Appears to be restricted to the left colon and rectum
Usually, but not always, pedunculated and left sided
May be associated with left sided carcinomas
Development of focal high grade dysplasia may represent an accelerated phase of carcinoma development
No clear association with sporadic MSI high carcinomas
Not typically a component of serrated adenomatous polyposis (hyperplastic polyposis)
It is now apparent that most, if not all, the polyps of that entity are sessile serrated adenoma
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