sessile serrated polyp pathology outlinesatanarjuat: the fast runner watch online with english subtitles

The polyp surveillance literature varies in terms used for predictors and outcomes and associated definitions (Table 3). Yantiss RK, Oh KY, Chen YT, Redston M, Odze RD. Dysplasia is the phenomena of disordered growth of the epithelial lining of the colon. fication of serrated polyps has evolved over the last two decades to recognize three major subtypes: hyperplastic polyp, sessile serrated ade-noma/polyp and traditional serrated adenoma. Dysplasia is the phenomena of disordered growth of the epithelial lining of the colon. Evidence suggests that up to one fifth of colorectal carcinomas develop from serrated polyps, named for their pattern of colonic crypts, and include the sessile serrated adenoma/polyp (SSA/P) that has malignant potential. Of all conventional adenomas, 2.1% of those ≤ 5 mm in size and 5.6% of those 6-9 mm in size were cancers ; Pathology Outlines - Sessile serrated adenom … Serrated polyposis syndrome (SPS) was formerly called hyperplastic polyposis syndrome. Both types need to be removed from your colon. Traditional serrated adenoma; Background. Histology. The surface epithelium has eosinophilic cytoplasm. 1, 2, 3 They are the precursor of most carcinomas arising via the serrated neoplasia pathway and as . Sessile serrated adenomas account for approximately 15% of all endoscopically removed polyps. sessile serrated adenoma, normal colon, hyperplastic polyp with perineuromatous stroma, other gastrointestinal polyps. Definition. Clinical and Pathologic Results. Mucosal hyperplasia, hyperplastic polyp and sessile serrated polyp/adenoma have quite similar appearances in the appendix They are distinguished architecturally as all lack cytologic dysplasia Architectural distortion due to obstructive changes may make the distinctions difficult The polyps are defined by their saw-toothed appearance under the microscope. Recent advances in endoscopic techniques have increased the detection rate of these polyps and have allowed removal of lesions up to 2 cm in diameter. 17% of gastric polyps are hyperplastic (Am J Gastroenterol 2009;104:1524) vs. up to 70% in older reports This could be due to increasing use of proton pump inhibitors and detection of fundic gland polyps (World J Gastroenterol 2016;22:8883, Dig Dis Sci 2009;54:1839, Arq Gastroenterol 2007;44:14) Occurs equally in males . According to the World Health Organization, there are three types of serrated lesions: Hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA/P) and traditional serrated adenomas (TSA). microvesicular serrated polyps (MVSPs), goblet cell serrated polyps (GCSPs) LM DDx. Mod Pathol. •50% >5 mm, 15-20% are >10 mm. As will be described, these lesions have multiple aliases (serrated adenoma, serrated polyp or serrated lesion among others), they hang out in a bad neighborhood (the poorly prepped right colon), they hide behind a mask of mucus, they are difficult for witnesses . The term 'traditional serrated' has slightly different features seen with the microscope than the more recently described sessile serrated adenoma. Serrated polyps comprise hyperplastic polyps, sessile serrated lesions (SSLs), and traditional serrated adenomas (TSAs). Traditional serrated adenomas - nuclear features of 'traditional adenoma' + serrated architecture. Polyposis syndrome defined by the development of numerous sessile serrated polyps in the colon Essential features. Histopathology showed a polyp with a serrated lumen extending to the crypts with dilated, 'boot-shaped' distortion of the basal architecture, surface mitoses and focal low-grade dysplasia (Figure 2). Serrated polyps (serrated adenomas) have a saw-tooth appearance under the microscope. SPS is a rare condition that is characterized by serrated polyps in the colon and/or rectum. References: 1. Stomach - Hyperplastic polyp. Evidence suggests that up to one fifth of colorectal carcinomas develop from serrated polyps, named for their pattern of colonic crypts, and include the sessile serrated adenoma/polyp (SSA/P) that has malignant potential. 2006 Dec;126(6):875-7. More On . sessile serrated polyp. Traditional serrated adenoma is a rare type of serrated polyp that accounts for <1% of all colorectal polyps. 291-297, 2010. It is a kind of physical screening in which thin tube is inserted into the body via colon and rectum. adenoma with serrated architecture. The mucin poor hyperplastic polyp (MPHP) accounts for <1% of hyper Of the 136 hyperplastic polyps, all 17 goblet-cell-rich hyperplastic polyps were negative for VE1 and 84 (71%) of the 119 microvesicular hyperplastic polyps were positive for VE1 Hyperplastic Polyp Subtype Microvesicular Mucin-poor Goblet cell rich Sessile Serrated Adenoma (SSA . According to the latest WHO classification, the family of SPs comprises hyperplastic polyps (HPs), sessile s … Colorectal perineuriomas are uncommon benign mucosal-based proliferations of mesenchymal cells that express perineurial markers, often associated with colonic crypts displaying a serrated/hyperplastic architecture. Modifiable lifestyle factors associated with risk of sessile serrated polyps, conventional adenomas and hyperplastic polyps. Hyperplastic polyp. Table 1 outlines the clinical and pathologic features of the sessile serrated adenomas/polyps with dysplasia included in this study. Classification: Summary of changes: • Sessile serrated lesion (SSL) is the new term for lesions formerly designated as sessile serrated adenoma (SSA). prominent serration at all levels, including base; basal crypts with branching, flask-shape (inverted T) architecture distortions: crypt crowding, horizontal crypts, crypt dilitation; mitosis in upper crypts; can be with or without dysplasia. Duodenal epithelial polyps have been reported in approximately 1.5% to 3.0% of individuals referred for upper endoscopy. Rarely in right colon or small intestine. Overall, there were 86 polyps . Notes: They are all considered pre-malignant, i.e. We have evalu … Not typically a component of serrated adenomatous polyposis (hyperplastic polyposis) It is now apparent that most, if not all, the polyps of that entity are sessile serrated adenomas; Robert V Rouse MD Amirkaveh Mojtahed MD Department of Pathology Stanford University School of Medicine Stanford CA 94305-5342 Serrated mucosal proliferations in the appendix lacking both architectural and cytological dysplasia; Diagnostic Criteria. A large serrated polyp was an independent risk factor for CRC, adjusted for histology, size and multiplicity of. In this report, normal colonoscopy refers to a colonoscopy where no adenoma, sessile serrated adenoma/polyp or sessile serrated polyp (SSP), hyperplastic polyp (HP) 10 mm, traditional serrated adenoma (TSA), or CRC was found. Cytologic features of pseudostratification and nuclear elongation are most useful in distinguishing traditional serrated adenomas from hyperplastic polyps and sessile serrated adenomas (Virchows Arch 2012;461:495) Ectopic crypts, goblet cells and eosinophilic cytoplasm are not distinguishing features since they may be present in sessile . if you leave 'em in place they often develop into cancer. SSA/Ps are typically located in the proximal colon and have molecular features of hypermethylation of CpG islands in gene promoters and activating point mutations (V600E) in . Although serrated polyps have in common a saw-tooth morphology of crypts, it is important to distinguish between hyperplastic polyps (HPs) and sessile serrated lesions (SSLs) because of the inherent difference in risk of malignant transformation [].This risk in turn informs colonoscopic surveillance intervals [1,2,3,4,5,6,7].Historically, colorectal polyps were classified as conventional . 2. WHO diagnostic criteria: (a) at least 5 serrated polyps proximal to the rectum, all ≥ 5 mm in size, with 2 or more of these being ≥ 10 mm; or (b) > 20 serrated polyps of any size . Renshaw AA, Kish R, Gould EW. Polyps occur throughout the gastrointestinal tract but are particularly common in the large bowel. remainder were sessile serrated polyps. What if my report uses the term serrated? eat a high-fat, low-fiber diet. Sessile serrated polyp pathology outlines. Subtypes. Selective expression of gastric mucin MUC6 in colonic sessile serrated adenoma but not in hyperplastic polyp aids in morphological diagnosis of serrated polyps. A sessile polyp was resected from the ascending colon. Hyperplastic polyp and sessile serrated adenoma: . Genetic mutations lead to cell growths at abnormally high rates. sessile serrated polyp; sessile serrated adenoma. 3. Mucosal hyperplasia, hyperplastic polyp and sessile serrated polyp have quite similar appearances in the appendix . entrapped crypts frequently hyperplastic/serrated 50-70% of cases. IHC. •15-25% of all serrated lesions . Members of the Working Group GI-Pathology of the German Society of Pathology, D. E. Aust, and G. B. Baretton, "Serrated polyps of the colon and rectum (hyperplastic polyps, sessile serrated adenomas, traditional serrated adenomas, and mixed polyps)—proposal for diagnostic criteria," Virchows Archiv, vol. Overall, the morphology is most in keeping with a traditional serrated adenoma. A comprehensive study of nondysplastic and dysplastic serrated polyps of the vermiform appendix. The term 'serrated adenoma' was introduced by Longacre and Fenoglio-Preiser, and later refined initially by Torlakovic et al, and then by others, to incorporate a spectrum of lesions, namely hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA; also called sessile serrated lesions in the UK and parts of Europe), and traditional . Unlike adenomas, not all serrated lesions are linked to colorectal cancer. Classification: Summary of changes: • Sessile serrated lesion (SSL) is the new term for lesions formerly designated as sessile serrated adenoma (SSA). 2006 Dec;126(6):875-7. Rubio CA. In contrast to sessile serrated lesions, hyperplastic polyps do not show serration to the crypt bases, branched crypts or dilated crypts. Sessile serrated polyps are common, found more in the proximal colon, and have low malignant potential if there is no dysplasia, and significant malignant potential if they are dysplastic. The 2010 WHO classification scheme divides this group into sessile serrated adenoma/polyp (SSA/P) and traditional serrated adenoma (TSA). Serrated adenomas of the appendix. The sessile serrated polyp (SSP), also known as sessile serrated adenoma, is the evil twin among the colorectal cancer precursors. Serrated Adenomas Sessile Serrated Adenoma/polyp Traditional serrated adenoma Serrated polyp, unclassified + dysplasia (low/high-grade) + high-grade dysplasia Hyperplastic polyp •Negative for high-grade dysplasia •TSA as a conventional adenoma •Serrated polyp, unclassified: serrated polyps with features indeterminate between one type and . Serrated adenocarcinoma is a recently described subset of colorectal cancer (CRC), which account for about 10% of all CRCs and follows an alternative pathway in which serrated polyps replace the traditional adenoma as the precursor lesion to CRC. Serrated adenomas, which are related to hyperplastic polyps, have malignant potential and are now considered neoplastic. TYPES OF SERRATED POLYPS UNTIL JULY 2019 October 2019 65% 30% 5% Hyperplastic polyp (HP) Microvesicular(MVHP) Goblet cell rich (GCHP ) Sessile Serrated adenoma/polyp (SSA/P) Traditional Serrated Adenoma (TSA) WHO 5TH ED. Hyperplastic polyp colon pathology outlines. It is also known as sessile serrated polyp (abbreviated SSP), sessile serrated lesion and sessile serrated adenoma/polyp (abbreviated SSA/P).In the United Kingdom, this entity and is known as a sessile serrated lesion, a terminology that is likely to be adopted in the 2019/5th edition WHO Blue Book. SSA is a premalignant lesion and has been linked to the serrated pathway of colorectal carcinoma which makes up about 15% of all colorectal cancers.SSA is more frequent in elderly females and in the right colon. In some cases, a cancer can arise in the Am J Clin Pathol. Am J Surg Pathol. 7 This occurs due to a range . 457, no. This distinction is important, as sessile serrated lesion can progress to malignancy, unlike its main differential diagnosis, hyperplastic polyp. Note: many gastroenterologists use the term "serrated polyp" to mean "sessile serrated adenoma/polyp Be cautious about using this as a descriptive term even though hyperplastic polyps are serrated too; Covered separately. Clinical. A review article by Seth D. Crockett and Iris D. Nagtegaal in the October issue of Gastroenterology . Sessile serrated adenoma (SSA) and sessile serrated polyp (SSP) are equivalent terms Hyperplastic polyps characteristically contain sawtooth pattern glands within the superficial aspect of the lesion. There are 2 types, which€look a little different under the microscope: Sessile serrated adenomas (also called sessile . Even the terminology of these lesions is not consistent either in the literature or in clinical use, with both sessile serrated polyp and sessile serrated adenoma in use. In addition to hyperplastic changes of the epithelium lining in a lipoma, rare cases of adenomatous transformation have been reported[ 6 , 7 ]. Given the many names and various, variably reproducible diagnostic criteria ascribed to sessile serrated lesion, confusion persists for many pathologists and gastroenterologists regarding the diagnosis. RECOMMENDED TERMINOLOGY October 2019 • Sessile serrated lesion (SSL) • Sessile serrated lesion with dysplasia (SSLD) TSA is usually easy to identify due to its protuberant pine cone-shape. The polyp can be inflammatory or neoplastic, benign or malignant. 1, 2, 3 They are the precursor of most carcinomas arising via the serrated neoplasia pathway and as such are responsible for 20-30% of all colorectal carcinomas. Serrated lesions of the colon are divided into conventional hyperplastic polyps and a new set of lesions that are variably called sessile serrated polyps (SSPs) and sessile serrated adenomas. Dr Yantiss presents a case of sessile serrated polyp (adenoma), a difficult issue at the forefront of the minds of many pathologists who diagnose colonic polyps. 2007 Nov;31(11):1742-53. Sessile serrated adenomas: New kid on the block. Comments: Introduction: Sessile serrated adenoma (SSA) (also referred to as sessile serrated polyp) is a relatively new entity that was first described in 1990. •Precursors to carcinoma with MSI and CpG island methylated MSS carcinoma Final surgical pathology . 5 cm. The distinction between sessile serrated adenoma (SSA) and traditional serrated adenoma (TSA) may be difficult using currently available criteria mostly based on cytologic characteristics. 8. Entrapped crypts frequently hyperplastic/serrated 50-70% of cases Changes of hyperplastic polyp or sessile serrated adenoma may occasionally predominate In such lesions, the perineurioma may surround just one or two crypts (Pai 2011) Usually ≤10 mm; Rarely up to 4.5 cm See also. Using molecular analysis, BRAF mutations have been demonstrated in the . Types of . Architectural distortion due to obstructive changes may make the distinctions difficult Approximately 25% of sporadic colorectal cancers (CRCs) arise from serrated precursor lesions, but there is confusion regarding their terminology, classification, and risk. For several years, the lack of consensus on definition, nomenclature, natural history, and biology of serrated polyps (SPs) of the colon has created considerable confusion among pathologists. Sessile serrated adenoma, abbreviated SSA, is a premalignant polyp of the large bowel.. An adenoma is a type of polyp that resembles the normal lining of your colon but differs in several important microscopic aspects. None developed into a malignant tumour. The portion of the lesion that looks like a conventional adenoma is the section demonstrated by microdissection to contain microsatellite instability. in such lesions, the perineurioma may surround just one or two crypts (pai 2011) usually ≤10 mm. right colon > 0.5 cm. Serrated polyps are a type of growth that stick out from the surface of the colon or rectum. sessile serrated adenoma or traditional serrated adenoma or adenoma (adenomatous polyp)? Serrated polyps form a heterogeneous group of colorec … The so-called serrated pathway describes the progression of sessile serrated adenomas and traditional serrated adenomas to colorectal cancer. A diagnosis of sessile serrated adenoma/polyp with low-grade dysplasia was made. Serrated polyps form a heterogeneous group of colorec … conventional adenoma with serrated architecture. Filiform serrated adenomas: a clinicopathologic and immunophenotypic study of 18 cases. H&E stain. This is done to view the internal health of the digestive tract and the rectum. WHO classification of colorectal serrated lesions and polyps Definition: Colorectal serrated lesions and polyps are characterised by serrated architecture of the epithelium. Several subtypes of serrated polyps, such as sessile serrated adenomas, traditional serrated adenomas, and mixed polyps, have been proposed to be colorectal carcinoma precursors. . Microsatellite instability is more common in sessile serrated polyps with cytologic dysplasia, which appear histologically to be a mixture of sessile serrated polyps and conventional adenomas. Understanding Your Pathology Report: Colon Polyps (Sessile or Traditional Serrated Adenomas) When your colon was biopsied, the samples taken were studied under the microscope by a specialized doctor with many years of training called a pathologist.The pathologist sends your doctor a report that gives a diagnosis for each sample taken. This causes the cells to grow abnormally, forming the tumors characteristic of a sessile serrated . 3, pp. 1 Traditional serrated adenoma constitutes one major category of serrated neoplasms . Sessile serrated adenoma/ polyp remains under-diagnosed while it represents up to 25% of all serrated polyps and is the precursor lesion to colorectal carcinoma Context: Solitary rectal ulcer syndrome (SRUS) is associated with erythema and ulceration of the rectal wall. Sessile Serrated Polyps of the Colon is caused by genetic mutations that results in dysplasia. A polyp is a projection (growth) of tissue from the inner lining of the colon into the lumen (hollow center) of the colon. changes of hyperplastic polyp or sessile serrated adenoma may occasionally predominate. Sessile serrated adenoma is associated with acute appendicitis in patients 30 years or older. 2018;67:456-465. "Serrated polyps" is the term used for epithelial lesions of the colon and rectum that have a "sawtooth" pattern on the polyp's surface and crypt epithelium. WHO diagnostic criteria: (a) at least 5 serrated polyps proximal to the rectum, all ≥ 5 mm in size, with 2 or more of these being ≥ 10 mm; or (b) > 20 serrated polyps of any size, distributed throughout the colon, with at least . This polyp has cytologic dysplasia and serrations at the surface; however, it does not have a villiform architecture. Adenoma / pathology* Adenoma / surgery Cell Transformation, Neoplastic* Colonic Polyps / pathology* . Polyp is a gross description or a clinical term used to describe a sessile or pedunculated mass protruding above the surface of mucosa and into the lumen. Serrated adenocarcinoma is a recently described subset of colorectal cancer (CRC), which account for about 10% of all CRCs and follows an alternative pathway in which serrated polyps replace the traditional adenoma as the precursor lesion to CRC. It helps to detect the presence of polyps in the colon or any tumorous growth . concomitant adenomas (OR 3.3; 95% CI 1.3 to 8.6). Sessile serrated adenoma is associated with acute appendicitis in patients 30 years or older. hyperplastic polyp. The purpose of this review is to address some of the more contentious issues around nomenclature, diagnostic criteria, histological variants, coexistence with other polyp types, the occurrence of . LM. Am J Clin Pathol. Serrated polyp. The sessile serrated polyp (SSP), also known as sessile serrated adenoma, is the evil twin among the colorectal cancer precursors. A slighly elevated sessile serrated adenoma of the ascending colon with a nodular surface that is partiall Sessile serrated adenoma/ polyps (SSA/P) •In the proximal colon. All colon and stomach polyps are more common in people who: are obese. Serrated adenomas of the appendix. The morphologic distinction between various serrated polyps of the colorectum may be challenging. eat a high-calorie diet . Davenport JR, Su T, Zhao Z, et al. Neoplastic polyps show epithelial dysplasia by definition and include adenomas and carcinomas. Twenty-three large serrated polyps found at screening were left in situ for a median of 11.0 years. The clinical significance of colon polyps arises from the fact that more than 95% of colon adenocarcinoma originate from polyps. SSA/Ps are typically located in the proximal colon and have molecular features of hypermethylation of CpG islands in gene promoters and activating point mutations (V600E) in . The surgical pathology files of the Ohio State University Medical Center, Columbus (1989 to 2008), were searched for appendiceal lesions originally diagnosed as any of the following: mucosal hyperplasia, hyperplastic polyp, sessile serrated adenoma, serrated adenoma, villous adenoma, tubular adenoma, tubulovillous adenoma, cystadenoma, or mucocele. What is the significance of the diagnosis of. Adenomas can be tubular, tubulovillous, or villous based on the glandular architecture. Renshaw AA, Kish R, Gould EW. 4, 5, 6 Carcinomas of the serrated pathway are overrepresented in studies of interval colorectal carcinomas. traditional serrated polyp. Of all conventional adenomas, 96 had high-grade dysplasia including 0.3% of adenomas ≤ 5 mm in size and 0.8% of adenomas 6-9 mm in size. 1 Duodenal epithelial polyps can occur as sporadic polyps, usually identified incidentally during upper endoscopy performed . Sessile Serrated Polyps of the Colon is caused by genetic mutations that results in dysplasia. unclassifiable serrated polyp with or without dysplasia. Comment Here Reference: Hyperplastic polyp Sessile serrated adenomas account for approximately 15% of all endoscopically removed polyps. serrated architecture at the surface without glandular abnormalities. Polyposis syndrome defined by the development of numerous sessile serrated polyps in the colon Essential features. The vast majority of cases arise distal to the splenic flexure and have been described as sessile polyps. 2008 Jun;21(6):660-9. A comprehensive study of nondysplastic and dysplastic serrated polyps of the vermiform appendix. Genetic mutations lead to cell growths at abnormally high rates. SSA/P may harbour dysplasia and the term sessile serrated adenoma with dysplasia (SSAD) is preferred for this subgroup. Am J Surg Pathol. Sessile serrated polyps are common among women and people who smoke. 2007 Nov;31(11):1742-53. What is an adenoma? Gastrointestinal pathology. rarely up to 4. Polyps that tend to grow as slightly flattened, broad-based polyps are referred to as sessile. Gastrointestinal polyps. This causes the cells to grow abnormally, forming the tumors characteristic of a sessile serrated . The term 'serrated adenoma' was introduced by Longacre and Fenoglio-Preiser, and later refined initially by Torlakovic et al, and then by others, to incorporate a spectrum of lesions, namely hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA; also called sessile serrated lesions in the UK and parts of Europe), and traditional . WHO classification of colorectal serrated lesions and polyps Definition: Colorectal serrated lesions and polyps are characterised by serrated architecture of the epithelium. The majority of studies suggest that both TSA and SSA/P hav e significant malignant Aim Traditional serrated adenoma (TSA) is an uncommon type of serrated adenoma that can be a precursor to biologically aggressive colorectal cancer that invokes the serrated (accelerated) pathway. Sessile serrated adenomas/polyps with cytologic dysplasia: a triple threat for interval cancer. Rubio CA. References ↑ Serrated neoplastic precursor lesion of colorectal cancer (Am J Gastroenterol 2012;107:1315) Defined as having 2 or 3 contiguous crypts demonstrating features of sessile serrated adenoma, as discussed below (per Bosman: WHO Classification of Tumours of the Digestive System, 4th Edition, 2010) ; Criteria for serrated polyposis syndrome include 1 of the following: As will be described, these lesions have multiple aliases (serrated adenoma, serrated polyp or serrated lesion among others), they hang out in a bad neighborhood (the poorly prepped right colon), they hide behind a . What is a polyp in the colon? Gut . Colonoscopy helps to confirm the diagnosis of sessile serrated adenoma of the colon. Adenoma... < /a > hyperplastic polyp lifestyle factors associated with acute appendicitis patients! More common in the sessile serrated polyp pathology outlines and/or rectum colon, hyperplastic polyp or sessile serrated adenoma occasionally... 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Neoplastic * Colonic polyps / pathology * adenoma / surgery cell Transformation, neoplastic Colonic. Large serrated polyps ( serrated adenomas - nuclear features of the digestive tract the. This study serrated neoplasia pathway and as may occasionally predominate presence of polyps in the large bowel perineuromatous stroma other. Dysplasia included in this study fibroblastic polyp ) of polyps in the colon or rectum, 2, 3 are. Oh KY, Chen YT, Redston M, Odze RD upper endoscopy performed: clinicopathologic... Adenoma / surgery cell Transformation, neoplastic * Colonic polyps / pathology * /... In place They often develop into cancer ( GCSPs ) LM DDx people who: are obese several important aspects. Occasionally predominate of 11.0 years pathway describes the progression of sessile serrated adenoma is associated with acute appendicitis in 30. < a href= '' https: //journalsblog.gastro.org/review-article-what-are-serrated-colorectal-polyps/ '' > hyperplastic polyp related to hyperplastic.... Differential diagnosis, hyperplastic polyp and sessile serrated adenoma with dysplasia included in this.! Often develop into cancer Chen YT, Redston M, Odze RD CI 1.3 to )!, i.e 2 types, which€look a little different under the microscope a diagnosis of serrated! D. Crockett and Iris D. Nagtegaal in the appendix ; + serrated architecture bases, branched crypts or dilated.. Been demonstrated in the colon Essential features, neoplastic * Colonic polyps / pathology.! Via colon and rectum adenomas/polyps with dysplasia included in this study colorectal carcinomas dysplasia ( SSAD ) is preferred this!

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