AI Article Synopsis
- There are very few cases of serrated lesions outside the low digestive tract, with only two traditional serrated adenomas (TSA) identified in the gallbladder prior to this report.
- A polypoid lesion was incidentally found during gallbladder surgery for cholecystitis, displaying unique epithelial characteristics and genetic markers.
- This case highlights an unusual TSA in the gallbladder that lacked typical genetic mutations, indicating the need for more research to better understand and manage these lesions.
Article Abstract
Serrated lesions outside the low digestive tract are scarce, with only two traditional serrated adenomas (TSA) reported in the gallbladder, with limited information about the serrated pathway outside the colon. Our case was an incidental finding in a patient undergoing surgery to treat a cholecystitis, when a polypoid lesion was observed. The epithelium formed gland structures with ectopic crypts, serrated slits and eosinophilic cytoplasm. MUC4 and MUC5A were positive, but mismatch repair proteins (MSI) retained nuclear staining. BRAF showed a not mutated profile and NRAS/KRAS was inconclusive due to the absence of remaining tissue. MSI and CpG island (CIMP), the most common genetic hallmarks of the serrated pathway, have been proven in gallbladder carcinomas, although serrated polyps are not recognized as premalignant precursors. Hereby we report one TSA of the gallbladder without the usual genetic drivers. A larger evidence is needed to improve the diagnosis and management.
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| http://dx.doi.org/10.1016/j.patol.2022.12.002 | DOI Listing |
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