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A sessile serrated lesion (SSL) is a premalignant flat (or sessile) lesion of the colon, predominantly seen in the cecum and ascending colon. SSLs are thought to lead to colorectal cancer through the (alternate) serrated pathway. [1] [2] This differs from most colorectal cancer, which arises from mutations starting with inactivation of the APC ...
Traditional serrated adenomas are a type of serrated polyp, and may occur sporadically or as a part of serrated polyposis syndrome. Traditional serrated adenomas are relatively rare, accounting for less than 1% of all colon polyps. [1] [2] Usually, traditional serrated adenomas are found in the distal colon and are usually less than 10 mm in ...
The common adenomas of the colon (colorectal adenoma) are the tubular, tubulovillous, villous, and sessile serrated (SSA). [18] A large majority (65–80%) are of the benign tubular type with 10–25% being tubulovillous, and villous being the most rare at 5–10%.
A sessile serrated adenoma is suspected in case of any of the following: [4] Size ≥0.5 cm; Location in right colon; If both are present, it is almost always an SSA. Other features causing a suspicion for sessile serrated adenoma are: [4] Dilation of crypts; Branching of crypts; Horizontal glands at the base; Mature mucinous cells at the base ...
Micrograph of a sessile serrated adenoma. H&E stain. Sessile serrated adenomas are characterized by (1) basal dilation of the crypts, (2) basal crypt serration, (3) crypts that run horizontal to the basement membrane (horizontal crypts), and (4) crypt branching. The most common of these features is basal dilation of the crypts.
Traditional serrated adenoma seen under microscopy with H&E stain, showing serrated crypts. SPS may occur with one of two phenotypes: distal or proximal. [6] The distal phenotype may demonstrate numerous small polyps in the distal colon and rectum, whereas the proximal phenotype may be characterized by relatively fewer, but larger polyps in the proximal colon (cecum, ascending colon, etc.). [6]
Tubular adenomas (tube-like shape) are the most common of the adenomatous polyps; they may occur everywhere in the colon and they are the least likely colon polyps to develop into colon cancer; Tubulovillous; Villous adenomas are commonly found in the rectal area and they are normally larger in size than the other two types of adenomas.
A physician's response to detecting an adenoma in a patient will vary according to the type and location of the adenoma among other factors. [ citation needed ] Different adenomas will grow at different rates, but typically physicians can anticipate the rates of growth because some types of common adenomas progress similarly in most patients.