Endoscopic and histologic characteristics of serrated lesions |
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Authors: | Driffa Moussata Gilles Boschetti Marion Chauvenet Karine Stroeymeyt Stéphane Nancey Fran?oise Berger Thierry Lecomte Bernard Flourié |
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Affiliation: | Driffa Moussata;Gilles Boschetti;Marion Chauvenet;Karine Stroeymeyt;Stéphane Nancey;Franoise Berger;Thierry Lecomte;Bernard Flourié;Department of Gastroenterology, Lyon Sud Hospital;Inserm Unit CREATIS - UMR5220 - INSERM1044,Lyon University;Department of Pathology,H?pital Lyon Sud;Department of Gastroenterology, Tours Hospital; |
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Abstract: | 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. |
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Keywords: | Hyperplastic polyp Traditional serrated adenoma Serrated polyposis Sessile serrated adenoma Endoscopy Endomicroscopy Histology |
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