CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(07): E1077-E1083
DOI: 10.1055/a-1452-9669
Original article

Nature of a white opaque substance visualized by magnifying endoscopy in colorectal hyperplastic polyps[*]

Akikazu Hirano
1  Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Kenshi Yao
1  Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Hiroshi Ishihara
2  Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Takashi Hisabe
2  Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Kentaro Imamura
2  Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Takao Kanemitsu
1  Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Kensei Ohtsu
2  Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Rino Hasegawa
1  Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Go Ikezono
1  Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Kazuhiro Takeda
1  Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Masaki Miyaoka
1  Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Toshiharu Ueki
2  Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Hiroshi Tanabe
3  Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Seiji Haraoka
3  Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Akinori Iwashita
3  Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
› Author Affiliations

Abstract

Background and study aims A white opaque substance (WOS) has been observed in the epithelia of gastric, duodenal, and colorectal epithelial adenomas and carcinomas, using magnifying endoscopy (ME). The WOS has been reported to be derived from a dense accumulation of minute lipid droplets in the epithelium. This study aimed to investigate whether the WOS in colorectal hyperplastic polyps was derived from lipid droplets accumulated in the epithelium, as observed in the case of gastric, duodenal, and colorectal epithelial neoplasms.

Patients and methods We analyzed 30 consecutive patients who were positive for the WOS, as visualized in colorectal hyperplastic polyps by ME with narrow-band imaging and 30 consecutive patients who were negative for the WOS. Biopsy specimens obtained from the polyps were immunostained with anti-adipophilin antibody to determine the correlation between the presence of the WOS and that of lipid droplets in the epithelium.

Results In all patients, the epithelial cells were histologically positive for adipophilin. However, the area of adipophilin-positive epithelial cells in the WOS-positive group was significantly larger than that in the WOS-negative group (P < 0.001). The density of the WOS was strongly and positively correlated with the area of adipophilin-positive cells.

Conclusions This study reveals that the WOS visualized in the superficial layers of colorectal hyperplastic polyps is produced by a dense accumulation of minute lipid droplets in the epithelia of the polyps.

* Meeting presentations: Asian Pacific Digestive Week 2019




Publication History

Received: 17 November 2020

Accepted: 23 February 2021

Publication Date:
17 June 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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