Skip to main content
SpringerLink
Log in

Pathological features of the sessile serrated adenoma/polyp with special references of its carcinogenesis

  • Review
  • Published:
Medical Molecular Morphology Aims and scope Submit manuscript

Abstract

The sessile serrated adenoma/polyp (SSA/P) has been thought as the relatively new precursor for the colorectal cancer. In the current review, the well-known pathological features including the histological definition of the SSA/P are described using the previous reports. Although the SSA/P is thought one of pre-cancerous lesions of the colorectal carcinoma, the decisive or documentary lesion like “carcinoma in adenoma” is very rare. In this review, the strict case of the carcinoma derived from the SSA/P is demonstrated using our cases. Although the genetic investigations of the SSA/P have shown the new pathway of colorectal carcinogenesis and these concepts are thought to be almost right, the verification for them should be performed using “the carcinoma in SSA/P” like the present case.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Snover DC, Ahnen DJ, Odze RD (2010) Serrated polyps of the colon and rectum and serrated polyposis. In: Bosman FT, Carneio F, Hruban RH, Theise N (eds) WHO classification of tumours. Pathology and genetics. Tumours of digestive system, 4th edn. International Agency for Research on Cancer, Lyon, pp 160–165

    Google Scholar 

  2. Hamatani S, Wada R, Tsujimoto S, Yanagita M, Mitsuda A, Hasegawa C, Aruki H, Yamashita S (1998) Nuclear morphometric study on colorectal polyps with epithelial serrated proliferation. J Jpn Soc Coloproctol 51:555–566 (in Japanese with English abstract)

    Article  Google Scholar 

  3. Hamatani S, Wada R, Tsujimoto S, Yanagita M, Mitsuda A, Hasegawa C, Kuwahata N, Yokouchi Y, Miura M (2001) Histomorphometric characteristics and cellular kinetics of colorectal polyps with epithelial serrated proliferation adjacent to carcinoma. Oncol Rep 8:49–55

    PubMed  CAS  Google Scholar 

  4. Hamatani S, Wada R, Morita A, Hasegawa C, Mitsuda A, Hatori T, Nonaka H, Takahashi K, Gomi S, Shibuya K (2005) Cellular kinetics and K-ras codon 12 mutations according to histomorphometric type of colorectal polyps with epithelial serrated proliferation. Oncol Rep 14:121–127

    PubMed  CAS  Google Scholar 

  5. Wada R, Abe H, Itakura M, Sato K, Matsukuma S, Kuwabara N, Suda K (1996) Pathological study on flat hyperplastic polyp of large bowel. J Jpn Res Soc Gastroenterol Carcinog 8:173–178 (in Japanese)

    Google Scholar 

  6. Ajioka Y, Watanabe H, Jass JR, Yokota Y, Kobayashi M, Nishikura K (1998) Infrequent K-ras codon 12 mutation in serrated adenomas of human colorectum. Gut 42:680–684

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Tonooka T, Sano Y, Fujii T, Kato S, Yoshino T, Fu KI, Hironaka S, Ochiai A, Yoshida S (2002) Adenocarcinoma in solitary large hyperplastic polyp diagnosed by magnifying colonoscope. Dis Colon Rectum 45:1407–1411

    Article  PubMed  Google Scholar 

  8. Sumner HW, Wasserman NF, McClain CJ (1981) Giant hyperplastic polyposis of the colon. Dig Dis Sci 26:85–89

    Article  PubMed  CAS  Google Scholar 

  9. Longacre TA, Fenoglio-Preiser CM (1990) Mixed hyperplastic adenomatous polyps/serrated adenomas: a distinct from of colorectal neoplasia. Am J Surg Pathol 14:524–537

    Article  PubMed  CAS  Google Scholar 

  10. Hayashi T, Yatani R, Apostol J, Stemmermann GN (1974) Pathogenesis of hyperplastic polyps of the colon: a hypothesis based on ultrastructure and in vitro cell kinetics. Gastroenterology 66:347–356

    PubMed  CAS  Google Scholar 

  11. Jass JR, Young J, Leggett BA (2000) Hyperplastic polyps and DNA microsatellite unstable cancers of the colorectum. Histopathology 37:295–301

    Article  PubMed  CAS  Google Scholar 

  12. Jass JR (2001) Serrated route to colorectal cancer: back street or super highway? J Pathol 193:283–285

    Article  PubMed  CAS  Google Scholar 

  13. Jass JR (2003) Hyperplastic-like polyps as precursors of microsatellite-unstable colorectal cancer. Am J Clin Pathol 119:773–775

    Article  PubMed  Google Scholar 

  14. Torlakovic E, Skovlund E, Snover DC, Torlakovic G, Nesland JM (2003) Morphologic reappraisal of serrated colorectal polyps. Am J Surg Pathol 27:65–81

    Article  PubMed  Google Scholar 

  15. Torlakovic EE, Gomez JD, Driman DK, Parfitt JR, Wang C, Benerjee T, Snover DC (2008) Sessile serrated adenoma (SSA) vs. traditional serrated adenoma (TSA). Am J Surg Pathol 32:21–29

    Article  PubMed  Google Scholar 

  16. Yao T, Sugai T, Iwashita A, Fujimori T, Kushima R, Nobuki M, Mitomi H, Ajioka Y, Konishi F (2011) Histopathological characteristics and diagnostic criteria of SSA/P. Project research “potential of cancerization of colorectal serrated lesions” of Japanese Society for Cancer of the Colon and Rectum. Stomach Intest 46:442–448 (in Japanese with English abstract)

    Google Scholar 

  17. Kashida H, Ikehara N, Hamatani S, Kudo SE, Kudo M (2011) Endoscopic characteristics of colorectal serrated lesions. Hepatogastroenterology 58:1163–1167

    Article  PubMed  Google Scholar 

  18. Burnett-Hartman AN, Newcomb PA, Phipps AI, Passarelli MN, Grady WM, Upton MP, Zhu LC, Potter JD (2011) Colorectal endoscopy, advanced adenomas, and sessile serrated polyps: implications for proximal colon cancer. Am J Gastroenterol 107:1213–1219

    Article  Google Scholar 

  19. Ishiguro S, Nomoto M, Obinata N, Oishi Y, Sato Y, Nakatsu S, Suzuki M, Ikeda Y, Maehata T, Kimura T, Watanabe Y, Nakajima T, Yamano HO, Yasuda H, Ito F (2012) Evaluation of magnifying colonoscopy in the diagnosis of serrated polyps. World J Gastroenterol 18:4308–4316

    Article  Google Scholar 

  20. Rosty C, Hewett DG, Brown IS, Leggett BA, Whitehall VLJ (2013) Serrated polyps of the large intestine: current understanding of diagnosis, pathogenesis, and clinical management. J Gastroenterol 48:287–302

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kimura T, Yamamoto E, Yamano H, Suzuki H, Kamimae S, Nojima M, Sawada T, Ashida M, Yoshikawa K, Takagi R, Kato R, Harada T, Suzuki R, Maruyama R, Kai M, Imai K, Shinomura Y, Sugai T, Toyota M (2011) A novel pit pattern identifies the precursor of colorectal cancer derived from sessile serrated adenoma. Am J Gastroenterol 107:460–469

    Article  Google Scholar 

  22. Dhir M, Yachida S, Neste LV, Glockner SC, Jeschke J, Pappou EP, Montgomery EA, Herman JG, Baylin SB, Donahue CLI, Ahuja N (2011) Sessile serrated adenomas and classical adenomas: an epigenetic perspective on premalignant neoplastic lesions of the gastrointestinal tract. Int J Cancer 129:1889–1898

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Fujita K, Yamamoto H, Matsumoto T, Hirahashi M, Gushima M, Kishimoto J, Nishiyama K, Taguchi T, Yao T, Oda Y (2011) Sessile serrated adenoma with early neoplastic progression: a clinicopathologic and molecular study. Am J Surg Pathol 35:295–304

    Article  PubMed  Google Scholar 

  24. Mohammadi M, Kristensen MH, Nielsen HJ, Bonde JH, Holck S (2012) Qualities of sessile serrated adenoma/polyp/lesion and its borderline variant in the context of synchronous colorectal carcinoma. J Clin Pathol 65:924–927

    Article  PubMed  CAS  Google Scholar 

  25. Hirano H, Ajioka Y, Watanabe H, Baba Y, Tozawa E, Nishikura K, Mukai G, Honma T, Aoyagi Y (2004) Bidirectional gastric differentiation in cellular mucin phenotype (foveolar and pyloric) in serrated adenoma and hyperplastic polyp of colorectum. Pathol Int 54:401–407

    Article  Google Scholar 

  26. Gibson JA, Hahn HP, Shahsafaei A, Odze RD (2011) MUC expression in hyperplastic and serrated colonic polyps: lack of specificity of MUC6. Am J Surg Pathol 35:742–749

    Article  PubMed  Google Scholar 

  27. Fujimori Y, Fujimori T, Imura J, Sugai T, Yao T, Wada R, Ajioka Y, Ohkura Y (2012) An assessment of the diagnostic criteria for sessile serrated adenoma/polyps: SSA/Ps using processing software analysis for Ki67 immunohistochemistry. Diagn Pathol 7:59

    PubMed  PubMed Central  Google Scholar 

  28. Jass JR (2005) Serrated adenoma of the colorectum and DNA-methylator phenotype. Nat Clin Pract Oncol 2:398–405

    Article  PubMed  CAS  Google Scholar 

  29. O’Brien MJ (2007) Hyperplastic and serrated polyps of the colorectum. Gastroenterol Clin N Am 36:947–968

    Article  Google Scholar 

  30. Kim KM, Lee EJ, Ha S, Kang SY, Jang KT, Park CK, Kim JY, Kim YH, Chang DY, Odze RD (2011) Molecular features of colorectal hyperplastic polyps and sessile serrated adenoma/polyps from Korea. Am J Surg Pathol 35:1274–1286

    Article  PubMed  Google Scholar 

  31. Kim MJ, Lee EJ, Chu SM, Jang SJ, Kim CH, Seo JP, Kim do S, Lee DH, Youk EG (2013) Pedunculated serrated polyp with histological features of sessile serrated adenoma: a clinicopathological and molecular study. Am J Surg Pathol 37:1039–1043

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Diagnostic Pathology, Juntendo University, Shizuoka Hospital, Izunokuni, 1129 Nagaoka, Izunokuni, Shizuoka, 410-2295, Japan

    Ryo Wada

  2. Division of Surgery, Sakura Gastroenterology and, Digestive Surgery Hospital, Susono, Japan

    Toshio Morimoto & Tatsuya Inayoshi

Authors
  1. Ryo Wada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshio Morimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tatsuya Inayoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ryo Wada.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wada, R., Morimoto, T. & Inayoshi, T. Pathological features of the sessile serrated adenoma/polyp with special references of its carcinogenesis. Med Mol Morphol 47, 123–129 (2014). https://doi.org/10.1007/s00795-014-0075-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00795-014-0075-y

Keywords

Search

Navigation