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Assessment of the Rectum and Anus01:25

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Serrated Colorectal Neoplasia.

Dale C Snover1, Kenneth P Batts2

  • 1Department of Pathology, Fairview Southdale Hospital, 6401 France Avenue South, Edina, MN 55435-2199, USA; Department of Laboratory Medicine and Pathology, The University of Minnesota Medical School, Minneapolis, Mayo Mail Code 609, 420 Delaware Street SE, Minneapolis, MN 55455, USA.

Surgical Pathology Clinics
|February 4, 2016
PubMed
Summary

Serrated lesions in the colon were once misclassified as benign hyperplastic polyps. New understanding clarifies the link between sessile serrated adenomas and cancer, focusing on diagnostic features.

Keywords:
AdenomaColorectalHyperplasticPolypSerratedSessile

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Area of Science:

  • Gastroenterology
  • Pathology
  • Oncology

Background:

  • Historically, serrated colorectal lesions lacking dysplasia were considered hyperplastic polyps with no malignant potential.
  • Recent advancements have improved understanding of the relationship between specific serrated lesions and colorectal cancer.
  • Unanswered questions remain regarding the precise classification and interrelationships of various serrated polyps.

Purpose of the Study:

  • To review and delineate the diagnostic features of various serrated colorectal lesions.
  • To discuss the evolving understanding of hyperplastic polyps, sessile serrated adenomas, and traditional serrated adenomas.
  • To explore serrated lesions in the context of inflammatory bowel disease and mechanical trauma.

Main Methods:

  • Review of current literature and pathological classifications of serrated colorectal lesions.
  • Analysis of diagnostic criteria for differentiating hyperplastic polyps, sessile serrated adenomas, and traditional serrated adenomas.
  • Discussion of clinical contexts associated with serrated lesions.

Main Results:

  • Sessile serrated adenoma (SSA) has a recognized pathway to colorectal carcinoma, unlike traditional hyperplastic polyps.
  • Distinguishing features between hyperplastic polyps, traditional serrated adenomas, and SSAs are crucial for risk stratification.
  • Serrated lesions can occur in specific conditions like idiopathic inflammatory bowel disease and following mechanical trauma.

Conclusions:

  • The classification and understanding of serrated colorectal lesions have significantly evolved.
  • Accurate identification of sessile serrated adenomas is critical due to their malignant potential.
  • Further research is needed to fully elucidate the spectrum and behavior of all serrated polyps.