vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2023.5.MORPH.1vmireaviz-830Research ArticleМорфология, патологияMorphology, pathologyМорфологические характеристики и диагностические критерии традиционной зубчатой аденомыMorphological characteristics and diagnostic criteria of traditional serrated adenomahttps://orcid.org/0000-0001-5635-6100ТертычныйА. С.TertychnyyA. S.

Тертычный Александр Семенович - д-р мед. наук, профессор, заведующий лабораторией электронной микроскопии и иммуногистохимии Института клинической морфологии и цифровой патологии,

ул. Трубецкая, д. 8/2, Москва, 119991

Aleksandr S. Tertychnyy - Dr. Sci. (Med.), Professor, Head of the Laboratory of Electron Microscopy and Immunohistochemistry of the Institute of Clinical Morphology and Digital Pathology,

 8/2 Trubetskaya str., Moscow, 119991

atertychnyy@yandex.ruhttps://orcid.org/0000-0002-8136-0117ПачуашвилиН. В.PachuashviliN. V.

Пачуашвили Нано Владимеровна - ординатор Института клинической морфологии и цифровой патологии,

ул. Трубецкая, д. 8/2, Москва, 119991

Nano V. Pachuashvili - Resident of the Institute of Clinical Morphology and Digital Pathology,

 8/2 Trubetskaya str., Moscow, 119991

npachuashvili@bk.ruhttps://orcid.org/0000-0002-4391-5441ПавловП. В.PavlovP. V.

Павлов Павел Владимирович - канд. мед. наук, заведующий отделением диагностической и лечебнойэндоскопии Университетской клинической больницы № 2,

ул. Трубецкая, д. 8/2, Москва, 119991

Pavel V. Pavlov - Cand. Sci. (Med.), Head of the Department of Diagnostic and Therapeutic Endoscopy of the University Clinical Hospital No. 2,

 8/2 Trubetskaya str., Moscow, 119991

pvpavlov@yandex.ruhttps://orcid.org/0000-0001-5685-8784КирюхинА. П.KiryukhinA. P.

Кирюхин Андрей Павлович - врач-эндоскопист отделения диагностической и лечебной эндоскопии  Университетской клинической больницы № 2,

ул. Трубецкая, д. 8/2, Москва, 119991

Andrey P. Kiryukhin - Endoscopist of the Department of Diagnostic and Therapeutic Endoscopy of the University Clinical Hospital No. 2,

 8/2 Trubetskaya str., Moscow, 119991

andresteam@mail.ruhttps://orcid.org/0000-0002-1792-5638ФедоренкоА. А.FedorenkoA. A.

Федоренко Александр Алексеевич - врач-эндоскопист отделения диагностической и лечебной эндоскопии Университетской клинической больницы № 2,

ул. Трубецкая, д. 8/2, Москва, 119991

Alexandr A. Fedorenko - Endoscopist of the Department of Diagnostic and Therapeutic Endoscopy of the University Clinical Hospital No. 2,

 8/2 Trubetskaya str., Moscow, 119991

shyra10@mail.ruhttps://orcid.org/0000-0002-4391-9776МареничН. С.MarenichN. S.

Маренич Наталья Сергеевна, канд. мед. наук, врач-эндоскопист отделения эндоскопии,

4-й Добрынинский пер., д. 1/9, Москва, 119049

Natal'ya S. Marenich - Cand. Sci. (Med.), endoscopist of the Department of Endoscopy,

1/9 4th Dobryninsky Lane, Moscow, 119049

nataliamarenich@mail.ruПервый московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationМорозовская детская городская клиническая больницаRussian FederationMorozovskaya City Children’s Clinical Hospital, Moscow Health DepartmentRussian Federation202323082023135614Copyright © Тертычный А.С., Пачуашвили Н.В., Павлов П.В., Кирюхин А.П., Федоренко А.А., Маренич Н.С., 20232023Тертычный А.С., Пачуашвили Н.В., Павлов П.В., Кирюхин А.П., Федоренко А.А., Маренич Н.С.Tertychnyy A.S., Pachuashvili N.V., Pavlov P.V., Kiryukhin A.P., Fedorenko A.A., Marenich N.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/830

Традиционные зубчатые аденомы (ТЗА) являются крайне редко встречающимися полипами из группы зубчатых полипов толстой кишки. ТЗА составляют не более 5 % от всех полипов толстой кишки. В отечественных работах данному гистологическому варианту посвящено сравнительно небольшое количество исследований, в то же время некоторые аспекты морфологической диагностики ТЗА до сих пор остаются не раскрытыми.

Цель

Цель: провести клинико-морфологический анализ случаев ТЗА.

Материалы и методы

Материалы и методы. В исследование было рассмотрено 57 случаев ТЗА, диагностированных в период с 2021 по 2023 год. В обнаруженных за данный период случаях был проведён анализ результатов гистологического и эндоскопического исследований.

Результаты

Результаты. Возраст пациентов варьировал от 44 до 78 лет и составил в среднем 61,7 года. Соотношение мужчин и женщин – 1:1,8. Большинство ТЗА были обнаружены в прямой (n = 28) и сигмовидной (n = 20) кишках. В восьми случаях опухоль локализовалась в нисходящем отделе и селезеночном изгибе ободочной кишки. В одном наблюдении опухоль была обнаружена в слепой кишке. Размеры полипов варьировали от 0,5 до 3,5 см. В 22 случаях в состав полипа, помимо ТЗА, входили тубуло-ворсинчатые аденомы (16 случаев) и гиперпластические полипы (6 случаев). В пяти случаях в материале ТЗА были выявлены очаги высокодифференцированной аденокарциномы.

Заключение

Заключение. ТЗА имеет характерные морфологические особенности с зубчатым экзофитным характером роста, цитоплазматической эозинофилией и наличием эктопических крипт. Из-за трудностей морфологической диагностики ТЗА в ряде случаев остаются недиагностированными. В то же время в виду повышенного злокачественного потенциала, ТЗА требуют особой настороженности со стороны патологов и клиницистов.

Traditional serrated adenomas (TSAs) are extremely rare polyps from the group of serrated polyps of the colon. TSAs is no more than 5 % of all colon polyps. A relatively small number of studies have been devoted to this histological variant, at the same time, some aspects of the morphological diagnosis of TSA still remain undisclosed. Purpose: to conduct a clinical and morphological analysis of cases of TSAs.

Materials and methods

Materials and methods. The study included 57 cases of TSAs diagnosed in the period from 2021 to 2023. In the cases detected during this period, the results of histological and endoscopic studies were analyzed.

Results

Results. The age of patients ranged from 44 to 78 years and averaged 61.7 years. The ratio of men and women is 1:1.8. Most TSAs were found in the rectum (n = 28) and sigmoid colon (n = 20). In 8 cases, the tumor was localized in the descending part and the splenic flexure of the colon. In 1 observation, a tumor was found in the cecum. The sizes of the polyps ranged from 0.5 cm to 3.5 cm. In 22 cases, the composition of the polyp included tubulovillous adenomas (16 cases) and hyperplastic polyps (6 cases) in addition to TSAs. In 5 cases, foci of highly differentiated adenocarcinoma were detected in the TSAs material.

Conclusion

Conclusion. TSAs has characteristic morphological features with a serrated exophytic growth pattern, cytoplasmic eosinophilia and the presence of ectopic crypts. Due to the difficulties of morphological diagnosis, TSAs in some cases remains undiagnosed. At the same time, due to the increased malignant potential, TSAs requires special vigilance on the part of pathologists and clinicians.

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The authors declare that there are no conflicts of interest present.