Image Description
Serrated Polyposis Syndrome (SPS): The 2010 WHO criteria for SPS include any one of the following features to be present: 1) at least 5 serrated polyps proximal to sigmoid colon; at least 2 of these should be greater than 1 cm in size. 2) any number of serrated polyps proximal to sigmoid colon in an individual with a first degree relative with SPS. 3) 20 or more serrated polyps of any size throughout the colon.
Most SPS cases are sporadic. Germline mutations have not been identified. These patients are at increased risk of multifocal colorectal carcinoma. They are monitored closely by colonoscopy.
The image shows a sessile serrated adenoma of right colon. Image courtesy of: Jian-Hua Qiao, MD, FCAP, Los Angeles, CA, USA; Used with permission.
About the Disease
Introduction: A gastrointestinal polyp is any discrete mass of tissue protruding into the lumen. They can occur anywhere in the GI tract but are most common in the colo-rectal region. They may be pedunculated (with a well-defined stalk) or sessile (broad-based with no stalk). Colonic polyps are subdivided into two major groups: non-neoplastic and neoplastic. Non-neoplastic group includes hyperplastic polyps, hamartomatous polyps (juvenile polyps, Peutz-Jeghers polyps), inflammatory polyps and mucosal polyps. Hamartomatous polyps in syndromic settings can show germline mutations in tumor suppressor genes or oncogenes and carry malignant potential. Submucosal lesions may also lift the mucosa giving it a polypoid appearance. Neoplastic polyps show epithelial dysplasia by definition and include adenomas and carcinomas. Adenomas can be tubular, tubulovillous, or villous based on the glandular architecture. Serrated adenomas, which are related to hyperplastic polyps, have malignant potential and are now considered neoplastic. References: 1. Feldman, M., Friedman, L. S., & Brandt, L. J. (2016). Sleisenger & Fordtrans Gastrointestinal & Liver Disease; 10th Edition. Philadelphia, PA. Elsevier Saunders. 2. Goldblum, J. R. et al (2018). Rosai and Ackermans Surgical Pathology; Eleventh Edition. Philadelphia, PA. Elsevier. 3. Kumar, V., Abbas, A. K., & Aster, J. C. (2015). Robbins and Cotran Pathologic Basis of Disease; Ninth Edition. Philadelphia, PA. Elsevier.