The Ewha Medical Journal  2012;35(1):44-48

doi:10.12771/emj.2012.35.1.44

Sessile Serrated Adenoma with High-grade Dysplasia.

Kyoung Joo KWON 1 ; Sung Ae JUNG ; Ki Nam SHIM ; Jung Hwa CHUNG ; Seok Hyung KANG ; Do Kyeung SONG ; Seung Jung JUN ; Hye In KIM

Affiliations

+expand

Keywords

Sessile serrated adenoma; Colorectal polyp; Hyperplastic polyp; Dysplasia

Country

Republic of Korea

Language

Korean

Abstract

Until recently, colorectal polyps were classified predominantly as hyperplastic or adenomatous. While adenomatous polyps are well-characterized precursor lesions of adenocarcinomas, hyperplastic polyps have been considered as benign lesion. However, some hyperplastic polyps with serrated morphology of the crypts have been recognized to have distinctive features and these polyps were termed 'serrated adenomas'. Recent data show that sessile serrated adenomas (SSA) might be the precursors of serrated colonic cancers, underlining the necessity of identifying them. SSA is approximately 3% of all polyps, commonly appears as flat or sessile and yellowish due to mucus production. In the pathogenesis of SSA, progression to high grade dysplasia or early invasive carcinoma may be associated with serrated neoplasia pathway different from adenoma-carcinoma sequence. We report a case with a colon polyp diagnosed as sessile serrated adenoma with high grade dysplasia after endoscopic submucosal dissection.