Endoscopic and histologic characteristics of serrated lesions

• Published in: World journal of gastroenterology : WJG Vol. 21; no. 10; pp. 2896 - 2904
• Main Authors: Moussata, Driffa, Boschetti, Gilles, Chauvenet, Marion, Stroeymeyt, Karine, Nancey, Stéphane, Berger, Françoise, Lecomte, Thierry, Flourié, Bernard
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 14.03.2015
• Subjects: adenoma;Se; Adenomatous Polyps - pathology; Adenomatous Polyps - physiopathology; Adenomatous Polyps - surgery; Chromogenic Compounds; Colonic Neoplasms - pathology; Colonic Neoplasms - physiopathology; Colonic Neoplasms - surgery; Colonic Polyps - pathology; Colonic Polyps - physiopathology; Colonic Polyps - surgery; Colonoscopy - methods; Diagnosis, Differential; Humans; Hyperplasia; Hyperplastic; Microscopy - methods; Minireviews; Narrow Band Imaging; polyp;Traditional; Precancerous Conditions - pathology; Precancerous Conditions - physiopathology; Precancerous Conditions - surgery; Predictive Value of Tests; Prognosis; serrated; Sessile serrated adenoma; Traditional serrated adenoma; Endomicroscopy; Hyperplastic polyp; Histology; Endoscopy; Serrated polyposis
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v21.i10.2896

In recent years , a second pathway for colonic carcinogenesis , distinct from the adenomatous pathway, has been explored. This is referred to as serrated pathway and includes three types of polyp,characterised by a serrated appearance of the crypts:hyperplastic polyps(HP),sessile serrated adenomas(SSA)or lesions,and traditional serrated adenomas.Each lesion has its own genetic,as well as macroscopic and microscopic morphological features.Because of their flat aspect,their detection is easier with chromoendoscopy(carmin indigo or narrow-band imaging).However,as we show in this review,the distinction between SSA and HP is quite difficult.It is now recommended to resect in one piece as it is possible the serrated polyps with a control in a delay depending on the presence or not of dysplasia.These different types of lesion are described in detail in the present review in general population,in polyposis and in inflammatory bowel diseases patients.This review highlights the need to improve characterization and understanding of this way of colorectal cancerogenesis.