What is tubular adenoma?

Tubular adenomas are more likely to occur in the elderly. The tumor grows very slowly and has no obvious symptoms. It is often discovered accidentally during a physical examination. Tubular adenoma is a relatively common type of colorectal adenoma. We must have a comprehensive understanding of this disease and take effective measures to treat it in a timely manner. So, what is tubular adenoma? Let’s take a closer look below.

Clinical characteristics of the onset age group are more common in people over 60 years old, with no gender difference. The tumor grows slowly and there is no pain or other subjective symptoms. Small in size, with diameter mostly less than 2cm. The palpation boundary is clear and active.

Pathological changes show a complete capsule and a smooth surface when observed with the naked eye . The cross section is brown-yellow and may contain cysts of varying sizes containing mucus. Microscopic observation of the substance: The tumor is composed of columnar or cuboidal epithelium, arranged in double layers, and anastomosing into irregular tubular or narrow trabecular shapes. The nuclei are large, oval, and uniform in size, and the cytoplasm is eosinophilic. There were no myoepithelial cells in the lumen or periphery of the trabeculae. The lumen contained PAS-positive secretions. Interstitium: loose, containing numerous capillaries and venules. The parenchyma and stroma are separated by a basement membrane.

Differential diagnosis of adenoid cystic carcinoma: biological characteristics of basal cell adenoma: the tumor grows slowly, is small in size, and has an intact capsule. Recurrence is rare after surgical resection. Histogenesis: The inner layer of cells is columnar, and the outer layer is basaloid cells, which are structurally similar to the excretory duct. It is speculated that its tissue origin may be the excretory duct epithelium. Tubular adenomas, also known as "adenomatous polyps," are the most common type of colorectal adenoma. The villous component of tubular adenomas accounts for less than 20%. Adenomas are spherical, ellipsoidal or irregular in shape, with a smooth or lobed surface, pink in color, solid in texture, and often have pedicles of varying lengths and thicknesses attached to the intestinal mucosa. However, when the tumor is only a few millimeters in size, it may also be broad-based with no visible pedicle. The larger the tubular adenoma, the greater the chance of malignancy. When the adenoma is >2cm, the rate of canceration increases significantly. If the tumor cells show obvious pleomorphism and interstitial infiltration, it is called severe atypical hyperplasia or carcinoma. Pathological changes of tubular adenoma: Macroscopic observation: complete capsule and smooth surface. The cross section is brown-yellow and may contain cysts of varying sizes containing mucus. Microscopic observation of tubular adenoma: Essence: The tumor is composed of columnar or cuboidal epithelium, arranged in double layers, and anastomosing to form irregular tubular or narrow trabecular shapes. The nuclei are large, oval, and uniform in size, and the cytoplasm is eosinophilic. There were no myoepithelial cells in the lumen or periphery of the trabeculae. The lumen contained PAS-positive secretions. Interstitium: loose, containing numerous capillaries and venules. The parenchyma and stroma are separated by a basement membrane. Endoscopic removal is the preferred method for treating tubular adenomas , and snare electrocautery resection can also be performed. This method has relatively little damage, mild reaction, good effect, etc.

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