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Pathology of Serrated Colon Adenomas

Definition

Serrated polyps of the large intestine consist of those that display a lumen with a serrated or stellate architecture. Until recently, serrated polyps were thought to consist only of reputedly benign and innocuous hyperplastic polyps (see the first image below). Recent discoveries have unveiled that, in addition to hyperplastic polyps, there exist other serrated lesions, for which the natural history is not as benign.
The current classification of serrated lesions of the large intestine includes: hyperplastic polyps, traditional serrated adenomas (see the second image below), and sessile serrated adenomas or polyps with or without cytologic dysplasia (see the last image below).
The terms “sessile serrated adenoma” and “sessile serrated polyp” are considered synonomous.

Hyperplastic polyp. Image courtesy of Mamoun Youne

Hyperplastic polyp. Image courtesy of Mamoun Younes, MD.

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Traditional serrated adenoma. Image courtesy of Ma

Traditional serrated adenoma. Image courtesy of Mamoun Younes, MD.

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Sessile serrated adenoma. Image courtesy of Mamoun

Sessile serrated adenoma. Image courtesy of Mamoun Younes, MD.

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