Anal SISCCAs have a low index of clinical suspicion, are associated with an absence of LVI and are linked to high-risk HPV. Prospective studies are needed to define the clinical behaviour of these anal tumours and to determine their best therapeutic strategy.
diagnosis in 16-27% of cases, resulting in one in five patients being given a histopathological grade different from the consensus (gold) standard. This problem may be alleviated by having multiple pathologists assess difficult cases, which can easily be done using WSI. The results of the present study show that alternative WSI-based assessment of laryngeal premalignancies will not compromise diagnostic accuracy. 1. van der Post RS, van der Laak JAWM, Sturm B et al. The evaluation of colon biopsies using virtual microscopy is reliable.Sir: Cap polyposis and colitis cystica profunda (CCP) are two rare, benign and distinct colorectal conditions whose aetiology remains unclear. A rare association between cap polyposis and CCP has already been described; in those cases, cystic glands were present in the submucosal layer of the cap polyps. 1,2 Interestingly, in the present case, lesions of CCP were not intermingled with cap polyps, but were distant from them.A 49-year-old man with chronic colitis located in the left colon and rectum, diagnosed as ulcerative colitis 5 years previously, was referred to our institution for persistent mucous bloody stools refractory to immunosuppressive therapies (infliximab). Prior colonoscopy revealed the presence of~50 sessile reddish polyps, mainly located in the rectosigmoid area. Biopsy specimens of the polyps showed superficial erosion with elongated hyperplastic glands and a mixed inflammatory infiltrate in the lamina propria. There was no atypia or dyplasia. Biopsy specimens of the intervening mucosa were not available. Laboratory values, including complete blood count, electrolytes, and serum protein, were within normal limits. Stool culture, ova and parasite examination and PCR for Clostridium difficile toxin B and cytomegalovirus were all negative. Despite the intake of infliximab, abdominal symptoms persisted, and the patient underwent a total proctocolectomy with anal preservation and end-ileostomy.
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