Histopathology of Serrated Adenoma, Its Variants, and Differentiation From Conventional Adenomatous and Hyperplastic Polyps

2007 ◽  
Vol 131 (3) ◽  
pp. 440-445
Author(s):  
Shuan C. Li ◽  
Lawrence Burgart
Keyword(s):  
Cancer Progression ◽  
Hyperplastic Polyp ◽  
Routine Practice ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
Comparable Rate ◽  
Traditional Serrated Adenoma ◽  
Gastrointestinal Pathology ◽  
Conventional Adenoma ◽  
Serrated Adenomas

Abstract Context.—Serrated adenomas can be morphologically subdivided into traditional and sessile types. They are thought to have a comparable rate of cancer progression like conventional adenomas, but they potentially have a faster rate of growth through methylation pathway(s). They share similar morphologic features with both the conventional adenoma and the hyperplastic polyp in a fashion that is different from a mixed adenoma and a hyperplastic polyp. Objective.—To describe the histopathologic features of traditional serrated adenoma and sessile serrated adenoma and their comparison with traditional adenomas and hyperplastic polyp. Data Sources.—Relevant articles in peer-review journals and the authors' working experience as practicing surgical pathologists with a specific interest in gastrointestinal pathology. Conclusions.—Both types of serrated adenomas, traditional serrated adenoma and sessile serrated adenoma, are morphologically distinct, clinically important entities, and they can be diagnosed accurately in routine practice.

The stem cell marker CD133 is highly expressed in sessile serrated adenoma and its borderline variant compared with hyperplastic polyp

2013 ◽  
Vol 66 (5) ◽  
pp. 403-408 ◽  
Author(s):  
Mahin Mohammadi ◽  
Michael Bzorek ◽  
Jesper Hansen Bonde ◽  
Hans J Nielsen ◽  
Susanne Holck
Keyword(s):  
Hyperplastic Polyp ◽  
Observer Variation ◽  
Stem Cell Marker ◽  
Routine Practice ◽  
Neoplastic Progression ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
Serrated Polyps ◽  
Cd133 Expression ◽  
Recorded Data

Non-dysplastic serrated polyps (ND-SP) represent a heterogeneous group of colorectal lesions that comprise hyperplastic polyp (HP) and the non-dysplastic subset of sessile serrated adenoma/polyp/lesion (SSA/P/L) and its borderline variant (BSSA/P/L). Given the observer variation in their histological typing, the identification of reliable markers that assist in the characterisation is warranted. Most important is the identification of polyp qualities that may reflect the patients’ risk of developing colorectal cancer. To address these issues, CD133 may represent a potential adjunct. Here we studied the discriminatory value of CD133 expression in the classification of ND-SPs and its distribution pattern in relation to synchronous colorectal carcinoma (SCRC). 39 SSA/P/Ls, 27 BSSA/P/Ls and 21 matched HPs were immunostained for CD133. The data were further correlated to the presence of SCRC and to polyp site and size. Ignoring SCRC status, CD133 was expressed more prominently in SSA/P/Ls than in HPs. The values for BSSA/P/Ls fell in between, yet closer to the SSA/P/L scorings. This observation was retained in the context of SCRC and for SSA/P/Ls not associated with SCRC. Right-sidedness and large size of the polyps more commonly associated with increased CD133 expression. CD133 expression was not a significant discriminator as to the SCRC status. BSSA/P/Ls are more closely aligned to SSA/P/L and further that SSA/P/L and BSSA/P/Ls fundamentally differ from HP by their CD133 immunoprofile, a notion that can be exploited in the diagnostic routine practice. Recorded data further indirectly support the idea that SSA/P/Ls are more prone to neoplastic progression than are HPs.

scholarly journals Sessile serrated adenoma of the appendix: literature review and clinical cases

2020 ◽  
Vol 1 (10) ◽  
pp. 105-109
Author(s):  
L. M. Mikhaleva ◽  
R. A. Vandysheva ◽  
I. S. Kozlov ◽  
O. A. Vasyukova ◽  
K. Yu. Midiber ◽  
...  
Keyword(s):  
Literature Review ◽  
Clinical Symptoms ◽  
Health Department ◽  
Endoscopic Examination ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
True Incidence ◽  
Moscow City ◽  
Serrated Adenomas ◽  
Clinical Cases

The article contains a literature review of clinical cases describing sessile serrated adenomas in the appendix from 1998 to 2018. Currently, it is still diffi cult to assess the true incidence of this pathology due to the fact that in most cases serrated adenomas are accidental fi ndings diagnosed after removing an inflamed appendix, since often, at small sizes, they do not cause clinical symptoms, do not bother patients and are inaccessible for endoscopic examination (if located behind its orifi ce). In addition, we present 2 clinical cases of sessile serrated adenoma of the appendix in patients who were admitted to the City Clinical Hospital No. 31 of the Moscow City Health Department in 2018 due to acute appendicitis, with a clinical and morphological characteristic, including a molecular genetics study.

scholarly journals Risk factors of traditional serrated adenoma and clinicopathologic characteristics of synchronous conventional adenoma

2019 ◽  
Vol 90 (4) ◽  
pp. 636-646.e9 ◽  
Author(s):  
Jeongseok Kim ◽  
Ji Young Lee ◽  
Sung Wook Hwang ◽  
Sang Hyoung Park ◽  
Dong-Hoon Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serrated Adenoma ◽  
Clinicopathologic Characteristics ◽  
Traditional Serrated Adenoma ◽  
Conventional Adenoma

scholarly journals Hyperplastic Polyp? Look Again... The Impact of the New Classification for Serrated Polyps

2014 ◽  
Vol 27 (3) ◽  
pp. 304 ◽  
Author(s):  
Catarina Fidalgo ◽  
Liliana Santos ◽  
Isadora Rosa ◽  
Ricardo Fonseca ◽  
Pedro Lage ◽  
...  
Keyword(s):  
World Health Organization ◽  
Colonic Polyps ◽  
World Health ◽  
Hyperplastic Polyps ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
World Health Organization Classification ◽  
Health Organization ◽  
The Impact ◽  
Serrated Adenomas

<p><span style="font-family: Times New Roman; font-size: small;"><strong>Introduction:</strong> The World Health Organization reviewed the classification for serrated colonic polyps in 2010. A new entity, sessile serrated adenoma, was included with two variants: with and without cytological dysplasia. This lesion’s malignant potential has been recognized and according to the new classification, many polyps may be reclassified. The impact of this change is yet to be assessed.<br /><strong>Objective:</strong> Analyze the proportion of lesions that were reclassified according to the new World Health Organization classification and the variables that influenced it.<br /><strong>Material and Methods:</strong> Every patient with at least one sessile serrated adenoma diagnosed in a 5 year period was included. All polyps (regardless of type) resected during the study period were reviewed. Data concerning polyp’s characteristics and patient variables were collected. Forty consecutive patients were included [13 female, mean age at 1st sessile serrated adenoma -59 yrs (34-80)].<br /><strong>Results:</strong> Were reviewed 247 polyps: hyperplastic - 42%; conventional adenomas - 29%; sessile serrated adenoma - 24%; serrated adenomas - 5%. Sixty-three polyps were reclassified: 43 hyperplastic, 12 serrated adenomas, 7 sessile serrated adenoma and 1 conventional adenoma with low grade dysplasia. Reclassification was significantly greater for hyperplastic polyps when compared with the other subtypes. Forty-three of one hundred and four (41%) hyperplastic polyps were reclassified all as sessile serrated adenoma. In these polyps the probability of reclassification was independent from polyp location but was greater if polyp size ≥ 5 mm.<br /><strong>Discussion: </strong>This is a single center, rectrospective study. The fact that it was done in an Oncology Referral Institution with a Family Risk Clinic may have influenced the results. Nevertheless the impressive reclassification rate for Hyperplastic Polyps and the fact that they were reclassified mainly as Serrated Adenomas makes these results relevant to daily practice.<br /><strong>Conclusion:</strong> Our results suggest that, according to the new World Health Organization classification for serrated colonic polyps, a considerable proportion of hyperplastic polyps will be reclassified. The serrated pathway of colorectal carcinogenesis has probably been underestimated and at-risk patients may have been under inappropriate surveillance.<br /><strong>Keywords: </strong>Colonic Neoplasms/diagnosis; Colonic Polyps/classification; World Health Organization; Neoplasm Grading.</span></p>

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