Slide of the Week: Colon Neoplasia, April 4, 2011

These two images display the histology of a neoplasm found in the colon. This neoplasm lacks the usual genetic markers associated with colorectal neoplasms.

Left: low magnification. Right: high magnification.

Your diagnosis is:
A.    Serrated Adenoma
B.    Sessile Polyp
C.    Hyperplastic polyp
D.    Flat Adenoma

Scroll below for answer.








Answer: D. Flat Adenoma

Comment: These lesions were initially identified over 20 years ago in Japan. However, they have now been recognized in the U.S. and Europe. They appear to have a lower frequency of Ras, p53 and other mutations which are commonly associated with other colorectal cancers. This suggests that flat adenomas represent a separate malignant pathway. Their biological significance and frequency is still controversial.

Click here to view the whole slide image.


Lau PC, Sung JJ. Flat adenoma in colon: two decades of debate. J Dig Dis. 2010. Aug;11(4):201-7. Review. PubMed PMID: 20649732.


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