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Pólipo colónico en varón de 82 años / Colonic polyp in 82 y-o male.

Antonio Félix Conde Martín

Servicio de Anatomía Patológica
Hospital Can Misses
C/ Corona s/n Ibiza
07800 Baleares

España
Comentado en:
PATOLOGIA
PATOCITO
FOROPAT
 Historia Clínica
Varón de 82 años con pólipo colónico a 28 cm del margen anal, con pedículo ancho, que se extirpa endoscópicamente.

Male 82 years old with colonic polyp located at 28 cm from anal margin, with wide pedicle, which is endoscopically excised.
 Iconografía
Imagen de Pólipo colónico en varón de 82 años / Colonic polyp in 82 y-o male.
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HE 40x.
Imagen de Pólipo colónico en varón de 82 años / Colonic polyp in 82 y-o male.
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HE 100x.
Imagen de Pólipo colónico en varón de 82 años / Colonic polyp in 82 y-o male.
Zoom
HE 200x.
Imagen de Pólipo colónico en varón de 82 años / Colonic polyp in 82 y-o male.
Zoom
HE 400x.
 Comentarios

 

El 21/3/2005 0:06, Oscar Marin dijo:

CLEAR CELL ADENOMA:

Adenoma containing clear cells, usually intermigle with more traditional Adenoma.

 

El 21/3/2005 1:24, Romualdo Correia Lins Filho dijo:

Dear friends

Although there is some resemblance to a metastatic renal clear cell carcinoma the cytoplasm of the clear cells is finely vacuolated, not empty as is frequently the case in clear cells of renal carcinomas. The tubules around the clear cell focus are definitely dysplastic. Finally, all the images were shot from the very same focus, probably because that was the only clear cell focus present within the polyp.

With all these considerations my diagnosis is ADENOMA WITH CLEAR CELL CHANGE.

Sincerely

Romualdo Lins

Caruaru - Pernambuco

Brasil

 

El 21/3/2005 2:31, Reynaldo Falcón-Escobedo dijo:

Adenoma tubular con células claras. Bellísimas fotos y una verdadera curiosidad de caso.

Tubular Adenoma with clear cell change. Beatiful pictures and a truly rare case.

Suzuki H. et al . Adenoma with clear cell change of the large intestine. Journal of Surgical Oncology. 67(3):182, 1998.

Saludos!

Reynaldo Falcón-Escobedo´

San Luis Potosí, S.L.P.

MEXICO

 

El 21/3/2005 7:48, Giorgio Gherardi dijo:

ADENOMA WITH CLEAR CELL CHANGE

See also: Domoto H, Terahata S, Senoh A, Sato K, Aida S, Tamai S. Clear cell change in colorectal adenomas: its incidence and histological characteristics. Histopathology. 1999 Mar;34(3):250-6.

Un caro saluto a tutti e Buona Pasqua!

 

El 21/3/2005 13:10, Túlio Souza dijo:

.

It’s unquestionable the adenoma lesion. The problem is the clear cells that have architecture similar to the colonic mucosa without dysplasia. As the other colleges I thing It’s a Clear cell adenoma, but I thing It can be an association of Adenoma with a Clear cell Hyperplastic Polyp (Mixed hiperplastic poliyp / Adenoma) as you can see in the WHO Blue Book – Tumors of the digestive system – Page 136.

The graduation of intestinal polyps is always a point of had debate, that’s why I’d like to know the opinion of the colleges about the graduation of the dysplasia. Low grade or high grade dysplasia????

Túlio Geraldo de Souza e Souza

Depto. de Anatomia Patológica

Hospital Aliança - Salvador - BA

tulio@hospitalalianca.com.br

.

 

El 21/3/2005 15:36, Reynaldo Falcón-Escobedi dijo:

Dear Tulio:

The base lesion of this interesting case corresponds with a classic colonic tubular adenoma and therefore by definition with low grade dysplasia. The clear cell change also corresponds -al least- with low grade dysplasia.

 

El 21/3/2005 19:38, Esther Contreras Valerio dijo:

Adenoma Tubular con células claras.

Saludos. Que el amor y el sacrificio del Señor Jesucristo nos recuerde siempre el amor de nuestro Dios y Padre Celestial. El Señor los bendiga.

Esther.

 

El 21/3/2005 23:11, Patricia Cabaleiro dijo:

Tubular adenoma with low-grade dysplasia and clear cell change.

AFIP Atlas of "Tumors of The Intestines", Third Series Fascicle 32, 2003 (p.11-113)

 

El 22/3/2005 12:17, Clóvis Klock dijo:

Tubular adenoma with clear cell change, low-grade dysplasia.

Clóvis Klock, MD

URI - CAMPUS DE ERECHIM

BRAZIL

 

El 22/3/2005 16:20, juan manuel dijo:

Adenoma tubular de cèlulas claras

 

El 22/3/2005 23:52, Maria Isabel Edelweiss dijo:

Acho que se trata de um adenoma tubular de baixo grau, com presença de células claras

Saludos

MIE

 

El 23/3/2005 6:53, Eze dijo:

Clear cell tubular adenoma of the colon with low grade dysplasia

 

El 23/3/2005 11:53, Kleber Simoes dijo:

The eventually seen clear cell change in adenomatous polyps of large bowel, represents a histochemically debatable phenomen, as to wether representing glycogen, lipid or mucin cytoplasmic acumulation.

However, the high proliferative index (Ki-67/MIB-1 labeling index) and p53 overexpression, described in 1999 Histopath. paper, suggests that clear cell change is a phenotipic change thar may harbor more "prone to malignant evolution" biological behavior in comparision with the "typical" low-grade adenoma in the vicinity.

Abraço a todos. Feliz páscoa.

Kleber Simões.

 

El 24/3/2005 3:34, Jarbas de Brito dijo:

A minha impressão é que se trata de um pólipo onde as células proliferantes, ao contrário do que habitualmente ocorre nos adenomas tubulares, se diferenciaram para um tipo terminal de célula da região, a célula mucosa mucossecretora (produtora de glicoproteína) com “microvacúolos” que na verdade são grânulos de secreção que não se coram com a HE, vistos claramente na última imagem. O aspecto sugere hiperplasia não ficando tão clara a idéia de displasia, uma vez que a diferenciação alcançou um tipo celular terminal de características maduras. Como as imagens parecem direcionar mais para o aspecto epitelial, não estando evidente o estroma para um exame mais detalhado fico com o diagnóstico de adenoma tubular.

Feliz Pascoa a todos.

 

El 28/3/2005 21:22, adely Gorg dijo:

I think this is a tubular adenoma with low grade dysplasia and clear cell change. I think it is usfel to examine other areas of the slide.
Hacer un comentario a este caso
 Diagnóstico
ADENOMA TUBULAR CON DISPLASIA DE BAJO GRADO Y CAMBIO DE CELULAS CLARAS / TUBULAR ADENOMA LOW GRADE WITH CLEAR CELL CHANGE.
 Comentario del Autor
Como se ha señalado, se trata de un adenoma tubular con cambio de células claras. Se observan dos tipos túbulos. Uno formado por células cilíndricas con pseudoestratificación nuclear y un leve grado de anaplasia nuclear. El otro está compuesto de células microvacuoladas de citoplasma claro. La importancia de reconocer esta rara lesión es saber que hay que descartar la posibilidad de un carcinoma renal metastásico a intestino 1.
No se ha demostrado peor comportamiento relacionado con esta curiosa lesión 2

As it has been pointed out, this is a tubular adenoma with clear cell change. You can see two types of tubules. One made of cilindrical cells with nuclear pseudoestratification and low grade of nuclear anaplasia. The other type is made of microvacuolated cells of clear cytoplasm. The importance of recognizing this rare lesion is to know that you must rule out a renal carcinoma metastatic to the intestine 1 .
It has not been demonstrated a worse behaviour related to this curious lesion 2

 Bibliografía
1 Ridell RH, Petras, RE, Williams GT, Sobin, LH.
Tumors of The Intestines.
Atlas of tumor pathology. Third Series, Fascicle 32, 2003 (p.111). Editor Juan Rosai. Washington DC.

2 Suzuki H, Ohta S, Tokuchi S, Moriya J, Fujioka Y, Nagashima K
Adenoma with clear cell change of the large intestine.
J Surg Oncol. 1998 Mar;67(3):182-185.
NOTA: Esto es un foro médico profesional, que no tiene como objetivo ofrecer consejo médico o de salud. Los mensajes enviados a este foro solicitando estos consejos, no serán atendidos. La información científica ofrecida está refrendada por las referencias y bibliografía correspondientes y de su veracidad son responsables sus autores. La participación en este Foro es gratuita.

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