Hyperplastic polyp or sessile serrated lesion? the contribution of serial sections to reclassification
Date
2020
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: The histological discrimination of hyperplastic polyps from sessile serrated lesions can be difficult.
Sessile serrated lesions and hyperplastic polyps are types of serrated polyps which confer different malignancy risks,
and surveillance intervals, and are sometimes difficult to discriminate. Our aim was to reclassify previously
diagnosed hyperplastic polyps as sessile serrated lesions or confirmed hyperplastic polyps, using additional serial
sections.
Methods: Clinicopathological data for all colorectal hyperplastic polyps diagnosed in 2016 and 2017 was collected.
The slides were reviewed and classified as hyperplastic polyps, sessile serrated lesion, or other, using current World
Health Organization criteria. Eight additional serial sections were performed for the confirmed hyperplastic polyp
group and reviewed.
Results: Of an initial 147 hyperplastic polyps from 93 patients, 9 (6.1%) were classified as sessile serrated lesions,
103 as hyperplastic polyps, and 35 as other. Of the 103 confirmed hyperplastic polyps, 7 (6.8%) were proximal, and
8 (7.8%) had a largest fragment size of ≥5mm and < 10 mm. After 8 additional serial sections, 11 (10.7%) were
reclassified as sessile serrated lesions. They were all less than 5mm and represented 14.3% of proximal polyps and
10.4% of distal polyps. An average of 3.6 serial sections were required for a change in diagnosis.
Conclusion: Histopathological distinction between hyperplastic polyps and sessile serrated lesions remains a
challenge. This study has uncovered a potential role for the use of additional serial sections in the morphological
reappraisal of small hyperplastic polyps, especially when proximally located.
Description
CITATION: Jaravaza, D. R. & Rigby, J. M. 2020. Hyperplastic polyp or sessile serrated lesion? the contribution of serial sections to reclassification. Diagnostic Pathology, 15:140, doi:10.1186/s13000-020-01057-0.
The original publication is available at https://diagnosticpathology.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
The original publication is available at https://diagnosticpathology.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
Keywords
Sessile serrated lesion, Adenoma, Polyps (Pathology)
Citation
Jaravaza, D. R. & Rigby, J. M. 2020. Hyperplastic polyp or sessile serrated lesion? the contribution of serial sections to reclassification. Diagnostic Pathology, 15:140, doi:10.1186/s13000-020-01057-0