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. 2001 Nov;54(11):849–853. doi: 10.1136/jcp.54.11.849

Serrated neoplasia of the stomach: a new entity

C Rubio 1
PMCID: PMC1731313  PMID: 11684719

Abstract

Aim—Despite the fact that gastric carcinoma continues to be one of the most common cancers world wide, only dysplasia in flat mucosa and adenomas have been shown to evolve into invasive carcinoma. The aim of this paper is to report a novel histological phenotype of gastric adenoma with early invasive growth.

Material and results—The patient presented with gastric complaints. A barium examination revealed an ulcerated tumour in the corpus, apparently infiltrating the gastric wall. The endoscopic examination showed a pediculated protruding tumour in the greater curvature. Punch biopsies were reported as invasive adenocarcinoma. Because of the poor condition of the patient, a partial gastrectomy was performed. The histological examination revealed elongated fronds with lateral crenated, saw tooth-like notches as a result of scalloped epithelial indentations. Areas with high grade dysplasia, with carcinoma in situ, and invasive carcinoma at the tip of the adenoma were demonstrated. The pedicle of the protruding neoplasia "emerged" from a non-protruding serrated adenoma.

Conclusions—The protruding serrated neoplasia had apparently evolved from a non-protruding serrated gastric adenoma. This appears to be the first case of gastric serrated neoplasia in the literature.

Key Words: gastric serrated neoplasia • gastric carcinoma • dysplasia • gastric adenoma

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Figure 1 Macrosection showing protruding, pedunculated gastric neoplastic lesion (haematoxylin and eosin).

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Figure 2 Low power view of the protruding neoplasm showing elongated fronds with lateral crenate, saw tooth-like notches resulting from scalloped epithelial indentations (haematoxylin and eosin; original magnification, x5).

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Figure 3 (A) Area demonstrating architectural variations in the serrated neoplasm (haematoxylin and eosin; original magnification, x10). (B) Area with invasive carcinoma found in the luminal aspect of the neoplastic lesion (MIB1 antibody; original magnification, x5).

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Figure 4 Gastric mucosa (of corpus type) surrounding the protruding neoplasm with hyperplastic, tall foveoli with serrated indentations (haematoxylin and eosin; original magnification, x10).

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Figure 5 Gastric mucosa surrounding the protruding neoplastic lesion showing hyperplastic, tall foveoli with serrated indentations lined with dysplastic cells (haematoxylin and eosin; original magnification, x10).

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Figure 6 Immunohistochemical study showing pronounced cell proliferation in the serrated indented epithelium of the neck of non-dysplastic glands (MIB1 antibody; original magnification, x10).

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Figure 7 Abrupt border between the normal gastric mucosa and the non-protruding mixed polyp (composed of hyperplastic, tall foveolar mucosa with serrated indentations), which surrounded the protruding neoplasm (haematoxylin and eosin; original magnification, x5).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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