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What Does My Pathology Report From A Colonoscopy Indicate?
Question: Can you explain in words I can understand the diagnosis on a pathology report from a colonoscopy I just had? Diagnosis of the largest polyp which was 30 mm says "foci of high grade dysplasia in fragments of tubulovillous adenoma. Adenomatous glands but not those with high grade dysplasia noted in areas showing cautery artifact"
This polyp was described as such: "There are fragments of colonic mucosa showing villous projections, increased numbers of glands, glandular crowing and mucho depletion. The glands are lined by enlarged cells with hyperchromatic nuclei showing pseudostratification. Some glands are crowded and show a complex architecture with cribriform gland formation. There is nuclear enlargement, hyperchromaticity and pseudostratification reaching the luminal surfaces. Prominent nucleoili, mitotic activity, mucin depletion and reduced numbers of goblet cells are also noted. These changes extend to the surface of the epithelium. Adenomatous glands but not those with high grade dysplasia are noted in areas showing cautery artifact.
I am a 38 year old female, first colonoscopy. Please help me understand these terms and if I should worry. Doctor is having me do a CAT scan next and repeat colonoscopy in 3 months but I haven't really had a discussion wit the doctor other than a brief phone call of which I didn't really understand much of what she said.
This polyp was described as such: "There are fragments of colonic mucosa showing villous projections, increased numbers of glands, glandular crowing and mucho depletion. The glands are lined by enlarged cells with hyperchromatic nuclei showing pseudostratification. Some glands are crowded and show a complex architecture with cribriform gland formation. There is nuclear enlargement, hyperchromaticity and pseudostratification reaching the luminal surfaces. Prominent nucleoili, mitotic activity, mucin depletion and reduced numbers of goblet cells are also noted. These changes extend to the surface of the epithelium. Adenomatous glands but not those with high grade dysplasia are noted in areas showing cautery artifact.
I am a 38 year old female, first colonoscopy. Please help me understand these terms and if I should worry. Doctor is having me do a CAT scan next and repeat colonoscopy in 3 months but I haven't really had a discussion wit the doctor other than a brief phone call of which I didn't really understand much of what she said.
Brief Answer:
Dysplasia is disordered growth - needs careful monitoring..
Detailed Answer:
Hi,
I am a pathologist. This query is been referred to me as your enquiry is related to explanation of laboratory test. I shall answer on behalf of gastroenterologist.
To answer you, I would like you to know the normal histology of colon first.
a. The colonic epithelium are single layered, columnar cells with small round nucleus.
b. The epithelium is composed of columnar cells and plenty of mucus secreting cells, also called as goblet cells.
c. The nucleus is normochromatic, normal light purple color (as seen on the slide).
d. Mitosis (cell division) is rarely seen.
e. All the glands are usually round, lined by single layered epithelium.
The notable findings in this report are:
a. Dysplasia - means disordered growth. The normal growth is altered - The glands looks different from normal.
b. Pseudostratification - stratification means multilayering. The epithelial cells are closely attached enough, that it appears to be stacked one above one. Increased cellularity is an abnormal feature.
c. Hyperchromatic - The nucleus is darker (indicates high nuclear activity)
d. Nuclear enlargement - The nucleus is enlarged showing increased mitosis (more cellular activity)
e. Tubulo villous adenoma - The glands shape are abnormal, arranged in tubules and also in form of villous (elevated mucosa lined by glands)
f. Mucin depletion and goblet cells reduced - The no. of goblet cells producing mucin is reduced
High grade dysplasia - means the glands disordered arrangement is too high indicating chances of progress are high. But this dysplasia (disordered growth) is only seen in few foci (at places).
Further the pathologist has noted cauterization artefact which is a finding seen when an instrument (cautery) is applied to stop bleeding.
Now these features are concerning. However not all high grade dysplasia or any dysplasia progress into malignancy. Since there is no invasian at present, I will not list cancer as the first possibility. It may be due to inflammation, local irritation or other causes. However in view concerning features, I will definitely recommend close and careful monitoring. CAT scan and repeat colonoscopy after 3 months is definitely recommended.
In the interim, maintain a fiber rich diet with Vit C. Avoid excess fat. Have a active life.
Hope it helps.
Any further queries, happy to help you again.
Dr. Jyothi BL
Dysplasia is disordered growth - needs careful monitoring..
Detailed Answer:
Hi,
I am a pathologist. This query is been referred to me as your enquiry is related to explanation of laboratory test. I shall answer on behalf of gastroenterologist.
To answer you, I would like you to know the normal histology of colon first.
a. The colonic epithelium are single layered, columnar cells with small round nucleus.
b. The epithelium is composed of columnar cells and plenty of mucus secreting cells, also called as goblet cells.
c. The nucleus is normochromatic, normal light purple color (as seen on the slide).
d. Mitosis (cell division) is rarely seen.
e. All the glands are usually round, lined by single layered epithelium.
The notable findings in this report are:
a. Dysplasia - means disordered growth. The normal growth is altered - The glands looks different from normal.
b. Pseudostratification - stratification means multilayering. The epithelial cells are closely attached enough, that it appears to be stacked one above one. Increased cellularity is an abnormal feature.
c. Hyperchromatic - The nucleus is darker (indicates high nuclear activity)
d. Nuclear enlargement - The nucleus is enlarged showing increased mitosis (more cellular activity)
e. Tubulo villous adenoma - The glands shape are abnormal, arranged in tubules and also in form of villous (elevated mucosa lined by glands)
f. Mucin depletion and goblet cells reduced - The no. of goblet cells producing mucin is reduced
High grade dysplasia - means the glands disordered arrangement is too high indicating chances of progress are high. But this dysplasia (disordered growth) is only seen in few foci (at places).
Further the pathologist has noted cauterization artefact which is a finding seen when an instrument (cautery) is applied to stop bleeding.
Now these features are concerning. However not all high grade dysplasia or any dysplasia progress into malignancy. Since there is no invasian at present, I will not list cancer as the first possibility. It may be due to inflammation, local irritation or other causes. However in view concerning features, I will definitely recommend close and careful monitoring. CAT scan and repeat colonoscopy after 3 months is definitely recommended.
In the interim, maintain a fiber rich diet with Vit C. Avoid excess fat. Have a active life.
Hope it helps.
Any further queries, happy to help you again.
Dr. Jyothi BL
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Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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