Specimens from Biopsies of Colorectal Polyps Often Harbor Additional Diagnoses

Shefali Chopra,Mark Li-Cheng Wu

doi:10.1155/2013/570526

Shefali Chopra, Mark Li-Cheng Wu

Open Access

https://doi.org/10.1155/2013/570526

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Abstract

Objectives. The utility of examining specimens from colorectal biopsies of polyps for nonneoplastic diseases is currently unknown. Our objectives were to characterize such additional diagnoses that could be rendered. Methods. We retrospectively and prospectively reviewed specimens from endoscopic biopsies of colorectal polyps obtained during routine screening or surveillance. Results. 17 of 168 specimens (10.1%) contained additional diagnoses, including schistosomiasis, eosinophilic colitis, intestinal spirochetosis, melanosis coli, and other entities. These findings were easily overlooked because they often affected mucosa that was spared by the polyps or were often evident only at high magnification. Schistosomiasis, eosinophilic colitis, and intestinal spirochetosis were clinically occult. Conclusions. Specimens from biopsies of colorectal polyps often harbor other diagnoses, in addition to polyps, and can be simultaneously screened for polyps and examined for nonneoplastic diseases. Detection of other diagnoses in addition to polyps requires awareness, examination at high magnification, and examination of areas spared by the polyps.

Highlights

Specimens from endoscopic biopsies of putative colorectal lesions usually show traditional nonserrated adenomas, serrated polyps, or variants of normal mucosa
We reviewed specimens from biopsies of colorectal polyps to characterize second diagnoses that could be rendered in this setting and to demonstrate that these specimens could be examined for nonneoplastic diseases
78 specimens were diagnosed as polyps by original pathologists in the 1-month interval

Summary

Introduction

Specimens from endoscopic biopsies of putative colorectal lesions usually show traditional nonserrated adenomas, serrated polyps, or variants of normal mucosa. These entities generally are and rapidly diagnosed at low magnification. Pathologists are tempted to examine these specimens quickly and only at low magnification, to assume that these specimens will harbor only polyps or variants of normal mucosa, and to refrain from examining these specimens further at high magnification once polyps are diagnosed. Directed review of these specimens might reveal other diagnoses, in addition to polyps. We reviewed specimens from biopsies of colorectal polyps to characterize second diagnoses that could be rendered in this setting and to demonstrate that these specimens could be examined for nonneoplastic diseases

Objectives

Methods

Results

Conclusion