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. This differs from most colorectal cancer, which arises from mutations starting with inactivation of the APC gene.
Multiple SSLs may be part of the serrated polyposis syndrome.
SSLs are generally asymptomatic. They are typically identified on a colonoscopy and excised for a definitive diagnosis and treatment.
serrated polyposis syndrome
The serrated polyposis syndrome (SPS) is a relatively rare condition characterized by multiple and/or large serrated polyps of the colon. Serrated polyps include SSLs, hyperplastic polyps, and traditional serrated adenomas. Diagnosis of this disease is made by the fulfillment of any of the World Health Organization’s (WHO) clinical criteria.
SSLs are diagnosed by their microscopic appearance; histomorphologically, they 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.
Unlike conventional colonic adenomas (e.g. tubular adenoma, villous adenoma), they do not (typically) have nuclear changes (nuclear hyperchromatism, nuclear crowding, elliptical/cigar-shaped nuclei).
Image:Sessile serrated adenoma 3 low mag.jpg|Low magnification [[micrograph]] of an SSL.
Image:Sessile serrated adenoma 3 intermed mag.jpg|Intermediate magnification micrograph of an SSL.
Image:Sessile serrated adenoma 2 high mag.jpg|High magnification micrograph of a SSL showing crypt branching.
Complete removal of a SSL is considered curative.
Several SSLs confer a higher risk of subsequently finding colorectal cancer and warrant more frequent surveillance. The surveillance guidelines are the same as for other colonic adenomas.
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Le polype colorectal ou polype colique est un polype du côlon et du rectum. Il s'agit d'un terme de description macroscopique qui renvoie à plusieurs types de tumeurs très différentes dans leur physiopathologie et leur pronostic médical. Polype sessile Polype pédiculé Polype adénomateux (Adénome colorectal) Adénome tubuleux Adénome tubulo-villeux Adénome villeux Polypes festonnés (ou Polypes crénelés ou Polypes dentelés) Polype hyperplasique Polype festonné traditionnel Adénome festonné sessile Autres poly
En médecine, un polype est une croissance anormale de tissus en saillie (adénome), ou tumeur bénigne, se développant sur les muqueuses. Certains sont plats (polypes sessiles), d'autres possèdent un pied plus ou moins long (polypes pédiculés). Les polypes se retrouvent plus fréquemment sur les muqueuses du côlon, du rectum, de l'utérus, de l'estomac, du nez, des sinus et de la vessie. Ils peuvent également se former ailleurs dans le corps, sur d'autres muqueuses, comme le col de l'utérus et l'intestin grêle.
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