Tubular Adenoma of the Colon

Most tubular adenomas are found during routine screening, such as colonoscopy, rather than because of symptoms. During colonoscopy, a healthcare professional uses a long, flexible tube attached to a video camera. This allows the health professional to view the whole colon and rectum on a video monitor.

If the healthcare professional sees any small growths, called polyps, they can often be removed right then. This is important because while most polyps are not cancerous, some can develop into cancer over time.

Tubular adenomas are characterized by the specific structure, which looks like branching tubelike glands under the microscope. Sometimes during the colonoscopy, the healthcare team can see specific patterns on the surface of the polyp using special imaging techniques. For example, brown slits within the glands can suggest the polyp might be a tubular adenoma.

While a colonoscopy helps find and remove these polyps, the final diagnosis is made by looking at the tissue under a microscope. This process helps ensure you receive the right treatment and follow-up monitoring.

Understanding your pathology report

When a polyp is removed, it’s sent to a lab for a specialist, called a pathologist, to examine under a microscope. This exam is called histopathology. It’s the most important step for a definitive diagnosis.

Common terms you might see on a pathology report include:

• Type of polyp. Your report may say tubular adenoma. That means the growth is not cancerous, also called benign. But because it has the potential to develop into cancer over time if not removed, it is considered precancerous.
• Size and location. The report usually states how large the polyp is and where in the colon or rectum it was found.
• Microscopic, called histologic, findings. This describes what the tissue looks like under the microscope. For example, tubular adenomas have a tubelike gland structure.
• Dysplasia grade. If the report says low-grade dysplasia, this means that the cells show early or mild changes. The risk of cancer is very low when the polyp is completely removed. If it says high-grade or focal high-grade dysplasia, this means an area of the polyp shows more-advanced precancerous change, but it is not cancer. Complete removal gets rid of the risk of the polyp turning into cancer.
• Margin status. If the polyp was removed in one piece, the report may say whether the edges, called margins, of the tissue are free of unusual cells. If there are no suspicious cells, your report will say negative margin. If there are remaining suspicious cells, it will say positive margin. This helps assess whether the removal was complete.
• High-risk features. The report may note whether the polyp had features that raise cancer risk, such as larger size, multiple adenomas, any villous (fingerlike) features or presence of high-grade dysplasia.
• Interpretation and follow-up recommendation. Some reports include a summary or note on what the findings mean for you and when you should return for another colonoscopy or follow-up.