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Villous Adenoma : Gross

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Villous adenomas show slender finger-like processes on the surface in 75% or more of the tumor. This accounts for granular appearance often seen in gross specimens. Pure villous adenomas are quite uncommon and make up between 3% and 15% of all colonic adenomas. Villous architecture is more frequently seen as a component in Tubulovillous adenomas. The larger the adenoma, the greater the frequency of villous component. Villous adenomas tend to be large and have greater degree of dysplasia.

The image shows a large villous adenoma (10 cm) that showed only focal high-grade dysplasia and no invasion. The tumor was located in the ascending colon and was discovered incidentally on a follow-up abdominal CT scan in a 65 y/o male with history of skin melanoma.

Image courtesy of: Laura G. Pastrin MD, La Paz University Hospital, Madrid, Spain.

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