Luminal Histological Outline and Colonic Adenoma Phenotypes

Abstract

Background: The luminal appearance of histological sections from colonic adenomas exhibits two different profiles: one regularly smooth and the other asymmetrically lumpy. These two modalities were compared to the size, the histological phenotype and the degree of epithelial neoplasia. Materials and Methods: For this purpose, the largest section of 107 consecutive endoscopically removed colonic adenomas was digitalized using an Epson Perfection 4990 PHOTO device. Profiles were enhanced with the Adobe Photoshop CS program. Results: Asymmetrically lumpy profiles were found in 96% (22/23) of the sections from adenomas measuring ≥15 mm, in 72% (39/54) of those having villous, mixed serrated or microtubular configurations and in 89% (24/27) showing carcinoma according to the Vienna classification. Conclusion: The asymmetrically lumpy profile of sections from endoscopically excised colonic adenomas correlated with the size of the sections, the histological phenotype and the degree of neoplastic transformation. Studies have been initiated to clinically explore whether the luminal configuration of colonic adenomas can be of help in predicting, before endoscopical removal, accepted histological parameters.