Multiple 'serrated adenocarcinomas' of the colon with a cell lineage common to metaplastic polyp and serrated adenoma. Case report of a new subtype of colonic adenocarcinoma with gastric differentiation

J Pathol. 2000 Mar;190(4):444-9. doi: 10.1002/(SICI)1096-9896(200003)190:4<444::AID-PATH520>3.0.CO;2-O.


A 70-year-old woman underwent right hemicolectomy and six carcinomas were recognized in the resected colon. These carcinomas were considered to be of a cell lineage common to serrated adenoma (SA) and hyperplastic (metaplastic) polyp (H/MP), because of the occurrence of multiple SAs and H/MPs around the carcinomas, as well as the co-existence of SA and H/MP areas within the carcinomas. These carcinomas had the following common histological and immunohistochemical features: a serrated structure resembling SA; a lace-like structure; infiltrative growth within the muscularis propria, with dedifferentiation at the invasive front; and immunohistochemical expression of pS2 and human gastric mucin. Based on these features, a new subtype of carcinoma is proposed, with a cell lineage common to SA and H/MP. It would also seem that p53 is involved in the serrated adenoma-carcinoma sequence.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / pathology*
  • Aged
  • Cell Lineage
  • Colonic Neoplasms / chemistry
  • Colonic Neoplasms / pathology*
  • Female
  • Humans
  • Immunohistochemistry
  • Intestinal Polyps / chemistry
  • Intestinal Polyps / pathology*
  • Mucins / metabolism
  • Neoplasm Invasiveness / pathology
  • Neoplasm Proteins / metabolism
  • Neoplasms, Multiple Primary / chemistry
  • Neoplasms, Multiple Primary / pathology*


  • Mucins
  • Neoplasm Proteins