This article will help you read and understand your pathology report for villous adenoma.
by Ipshita Kak, MD FRCPC, updated on August 13, 2020
The colon is a part of the gastrointestinal tract which also includes the mouth, esophagus, stomach, small bowel, and anus. The colon is a long hollow tube that starts at the small bowel and ends at the anal canal. The colon is divided into sections which include the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum.
The functions of the colon are to absorb water from the food that we eat and to move waste out of the body.
The colon is made up of six layers of tissue:
Villous adenomas are important because some will develop changes that can lead to a type of colon cancer called adenocarcinoma over time.
Examination of the colon in a procedure known as a colonoscopy and removal of any polyps has been shown to reduce the risk of developing colon cancer in older adults.
The type, size, and number of polyps removed at your first colonoscopy will determine the period within which your doctor will ask you to come back for a follow-up endoscopy.
When examined under the microscope, villous adenomas are made up of cells that show an abnormal pattern of growth. Pathologists call this abnormal pattern of growth dysplasia. Dysplasia in the colon is important because it is considered a precancerous condition that can turn into a cancer over time.
In the colon, pathologists divide dysplasia into two categories called low grade dysplasia and high grade dysplasia. All villous adenomas show at least low grade dysplasia. Your pathologist will carefully examine your tissue sample to look for any high grade dysplasia.
he risk for developing cancer is greater with high grade dysplasia.
In the colon, a margin is any tissue that was cut by the surgeon in order to remove the villous adenoma from your body. Some villous adenomas grow on a piece of tissue called a stalk and the adenoma is removed by cutting the stalk. In these cases, the margin is the part of the stalk that is cut.
High grade dysplasia at the edge of the margin means that the abnormal tissue may not have been completely removed from the body.
Villous adenomas are often removed and sent to pathology as multiple pieces (fragments) of tissue. In some of these cases, it will not be possible for your pathologist to determine which piece is the real margin and the changes seen at the margin will not be described in your report.