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The serrated polyposis syndrome (SPS) is a relatively rare condition characterized by multiple and/or large serrated polyps of the colon. Serrated polyps include SSLs, hyperplastic polyps, and traditional serrated adenomas. Diagnosis of this disease is made by the fulfillment of any of the World Health Organization's (WHO) clinical criteria. [4]
A sessile serrated adenoma or traditional serrated adenoma is suspected if there is either of the following: [4] Nuclear stratification; Loss of polarity; Dysplasia; 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.
Colorectal adenoma Type Risk of containing malignant cells Histopathology definition Tubular adenoma 2% at 1.5 cm [4] Over 75% of volume has tubular appearance. [5] Tubulovillous adenoma 20% to 25% [6] 25–75% villous [5] Villous adenoma 15% [7] to 40% [6] Over 75% villous [5] Sessile serrated adenoma (SSA) [8] Basal dilation of the crypts ...
Neoplastic polyps of the bowel are often benign hence called adenomas. An adenoma is a tumor of glandular tissue, that has not (yet) gained the properties of cancer. [citation needed] The common adenomas of the colon (colorectal adenoma) are the tubular, tubulovillous, villous, and sessile serrated (SSA). [18]
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]
Sessile serrated adenoma: Colorectal Similar to hyperplastic with hyperserration, dilated/branched crypt base, prominent mucin cells at crypt base Yes Serrated polyposis syndrome: Inflammatory Non-specific Raised mucosa/submucosa with inflammation If dysplasia develops Inflammatory bowel disease, ulcers, infections, mucosal prolapse
[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. [citation needed] Two common responses are removing the adenoma with surgery and then monitoring the patient according to established guidelines.
Sessile Serrated Adenoma, Transverse Colon, 0.4 cm. Pathological and histological images courtesy of Ed Uthman at flickr. Date: 16 June 2009, 11:12: Source: Sessile Serrated Adenoma, Transverse Colon, 0.4 cm. Uploaded by CFCF; Author: Ed Uthman from Houston, TX, USA