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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 ...
The risks of progression to colorectal cancer increase if the polyp is larger than 1 cm and contains a higher percentage of villous component. Also, the shape of the polyps is related to the risk of progression into carcinoma. Polyps that are pedunculated (with a stalk) are usually less dangerous than sessile polyps (flat polyps). Sessile ...
Sessile serrated adenoma seen under microscopy with H&E stain. Serrated polyposis syndrome often does not cause symptoms. The risk of colon cancer is between 25 and 40%. [8] Sessile serrated polyps, as seen during endoscopy or colonoscopy, are flat (rather than raised) and are easily overlooked.
The pathophysiology of precancerous lesions is thought to be similar to that of cancer, and also varies depending on the disease site and type of lesion. [12] It is thought that cancer is always preceded by a clinically silent premalignant phase during which many oncogenic genetic and epigenetic alterations accumulate before it is truly malignant.
The Haggitt's criteria is used for classification of polyps containing cancer and is based on the depth of penetration. [9] The Haggitt's criteria has level 0 through level 4, with all invasive carcinoma of sessile polyp variant by definition being classified as level 4. [9] Level 0: Cancer does not penetrate through the muscularis mucosa. [9]
In the photo, an apparent field defect in this segment of a colon has generated four polyps (labeled with the size of the polyps, 6mm, 5mm, and two of 3mm, and a cancer about 3 cm across in its longest dimension). These neoplasms are also indicated, in the diagram below the photo, by 4 small tan circles (polyps) and a larger red area (cancer).
This outpatient procedure, performed under sedation, allows doctors to identify and remove polyps — soft tissue growths that can develop into cancer. Since polyps affect roughly 20% to 30% of ...
Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat. Cancer is fundamentally a disease of tissue growth regulation. For a normal cell to transform into a cancer cell, the genes that regulate cell growth and differentiation must be altered. [98] The affected genes are divided into two broad categories.