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Review

Small Bowel Epithelial Precursor Lesions: A Focus on Molecular Alterations

1
Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy
2
Pathology Unit, Department of Surgical and Diagnostic Sciences, University of Genoa and Ospedale Policlinico San Martino University Hospital, 16132 Genoa, Liguria, Italy
3
Pathology Unit, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Lombardy, Italy
4
Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Andrea Nicolini
Int. J. Mol. Sci. 2021, 22(9), 4388; https://doi.org/10.3390/ijms22094388
Received: 2 March 2021 / Revised: 18 April 2021 / Accepted: 20 April 2021 / Published: 22 April 2021
(This article belongs to the Special Issue Molecular Alterations in GastroIntestinal Pre-invasive Lesions)
The wider use of gastrointestinal endoscopic procedures has led to an increased detection of small intestinal preneoplastic and neoplastic epithelial lesions, most of which are identified in the duodenum and ampullary region. Like their malignant counterparts, small intestinal glandular precursor lesions, which include adenomas and hamartomas, may arise sporadically or be associated with hereditary tumor syndromes, such as familial adenomatous polyposis, MUTYH-associated polyposis, Lynch syndrome, Peutz-Jeghers syndrome, juvenile polyposis syndrome, and Cowden syndrome. In addition, dysplastic, preinvasive lesions have been observed adjacent to small bowel adenocarcinomas complicating immune-related disorders, such as celiac or Crohn’s disease. Adenomatous lesions may exhibit an intestinal-type, gastric-type, or, very rarely, serrated differentiation, related to different molecular pathogenetic mechanisms. Finally, in the background of multiple endocrine neoplasia 1 syndrome, precursor neuroendocrine growths have been described. In this review we offer a comprehensive description on the histo-molecular features of the main histotypes of small bowel epithelial precursors lesions, including: (i) sporadic adenomas (intestinal-type and gastric-type; non-ampullary and ampullary); (ii) syndromic adenomas; (iii) small bowel dysplasia in celiac and Crohn’s disease; (iv) serrated lesions; (v) hamartomatous lesions; and (vi) neuroendocrine precursor lesions. View Full-Text
Keywords: adenoma; ampulla; APC; celiac disease; Crohn’s disease; GNAS; hamartoma; neuroendocrine; polyposis; small intestine adenoma; ampulla; APC; celiac disease; Crohn’s disease; GNAS; hamartoma; neuroendocrine; polyposis; small intestine
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MDPI and ACS Style

Vanoli, A.; Grillo, F.; Furlan, D.; Arpa, G.; Grami, O.; Guerini, C.; Riboni, R.; Mastracci, L.; Di Sabatino, A. Small Bowel Epithelial Precursor Lesions: A Focus on Molecular Alterations. Int. J. Mol. Sci. 2021, 22, 4388. https://doi.org/10.3390/ijms22094388

AMA Style

Vanoli A, Grillo F, Furlan D, Arpa G, Grami O, Guerini C, Riboni R, Mastracci L, Di Sabatino A. Small Bowel Epithelial Precursor Lesions: A Focus on Molecular Alterations. International Journal of Molecular Sciences. 2021; 22(9):4388. https://doi.org/10.3390/ijms22094388

Chicago/Turabian Style

Vanoli, Alessandro, Federica Grillo, Daniela Furlan, Giovanni Arpa, Oneda Grami, Camilla Guerini, Roberta Riboni, Luca Mastracci, and Antonio Di Sabatino. 2021. "Small Bowel Epithelial Precursor Lesions: A Focus on Molecular Alterations" International Journal of Molecular Sciences 22, no. 9: 4388. https://doi.org/10.3390/ijms22094388

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