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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]
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]
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]
Serrated polyposis syndrome is a rare condition that has been defined by the World Health Organization as either: [3] ≥5 serrated lesions/polyps proximal to the rectum, all ≥ 5 mm in size, with two lesions ≥10 mm >20 serrated lesions/polyps of any size distributed throughout the large bowel with 5 proximal to the rectum.
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.
A polyp is an abnormal growth of tissue projecting from a mucous membrane. If it is attached to the surface by a narrow elongated stalk, it is said to be pedunculated; if it is attached without a stalk, it is said to be sessile. Polyps are commonly found in the colon, stomach, nose, ear, sinus(es), urinary bladder, and uterus.
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For example, adenomatous polyps in the colon may be pedunculated (lobular head with a long slender stalk) or sessile (broad base). The adenomatous proliferation is characterized by different degrees of cell dysplasia ( atypia or loss of normal differentiation of epithelium) irregular cells with hyperchromatic nuclei, stratified or ...