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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 ...
Sessile serrated polyps, as seen during endoscopy or colonoscopy, are flat (rather than raised) and are easily overlooked. Serrated lesions range in size from small (<5 mm) to large, and often have a "mucous cap" overlying the polyp. Serrated lesions are frequently located on the folds of the colon (haustral folds). [citation needed]
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.
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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.
Sessile polyps have a shorter pathway for migration of invasive cells from the tumor into submucosal and more distant structures, and they are also more difficult to remove and ascertain. Sessile polyps larger than 2 cm usually contain villous features, have a higher malignant potential, and tend to recur following colonoscopic polypectomy. [18]
Traditional serrated adenoma is a premalignant type of polyp found in the colon, often in the distal colon (sigmoid, rectum). 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 ...
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