Tran TH, Nguyen VH, Vo DT. How to "pick up" colorectal serrated lesions and polyps in daily histopathology practice: From terminologies to diagnostic pitfalls. World J Clin Oncol 2024; 15(9): 1157-1167 [PMID: 39351466 DOI: 10.5306/wjco.v15.i9.1157]
Corresponding Author of This Article
Diem TN Vo, MD, PhD, Chief Doctor, Senior Lecturer, Department of Histology-Embryology and Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh 700000, Viet Nam. votngocdiem@ump.edu.vn
Research Domain of This Article
Pathology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Sep 24, 2024; 15(9): 1157-1167 Published online Sep 24, 2024. doi: 10.5306/wjco.v15.i9.1157
How to "pick up" colorectal serrated lesions and polyps in daily histopathology practice: From terminologies to diagnostic pitfalls
Thai H Tran, Vinh H Nguyen, Diem TN Vo
Thai H Tran, Department of Pathology, Da Nang Hospital, Da Nang 50000, Viet Nam
Vinh H Nguyen, Diem TN Vo, Department of Pathology, University Medical Center Ho Chi Minh City, Ho Chi Minh 70000, Viet Nam
Diem TN Vo, Department of Histology-Embryology and Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 70000, Viet Nam
Co-first authors: Thai H Tran and Vinh H Nguyen.
Author contributions: Tran TH was primarily responsible for drafting the manuscript and preparing the figures and tables; Nguyen VH contributed significantly by providing critical input and revisions to the manuscript; Vo DTN was instrumental in conceptualizing the review, designing the structure of the manuscript, and overseeing the coordination of the writing process.
Conflict-of-interest statement: The authors have disclosed that they have no significant relationships with or financial interest in any commercial companies mentioned in this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Diem TN Vo, MD, PhD, Chief Doctor, Senior Lecturer, Department of Histology-Embryology and Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh 700000, Viet Nam. votngocdiem@ump.edu.vn
Received: May 19, 2024 Revised: June 27, 2024 Accepted: July 31, 2024 Published online: September 24, 2024 Processing time: 102 Days and 2.8 Hours
Abstract
Over the last decade, our knowledge of colorectal serrated polyps and lesions has significantly improved due to numerous studies on this group of precursor lesions. Serrated lesions were misleading as benign before 2010, but they are currently reclassified as precancerous lesions that contribute to 30% of colorectal cancer through the serrated neoplasia pathway. The World Health Organization updated the classification for serrated lesions and polyps of the colon and rectum in 2019, which is more concise and applicable in daily practice. The responsible authors prescribe that “colorectal serrated lesions and polyps are characterized by a serrated (sawtooth or stellate) architecture of the epithelium.” From a clinical standpoint, sessile serrated lesion (SSL) and SSL with dysplasia (SSLD) are the two most significant entities. Despite these advancements, the precise diagnosis of SSL and SSLD based mainly on histopathology remains challenging due to various difficulties. This review describes the nomenclature and the terminology of colorectal serrated polyps and lesions and highlights the diagnostic criteria and obstacles encountered in the histopathological diagnosis of SSL and SSLD.
Core Tip: The “serrated neoplastic pathway”, a crucial and significant aspect of our comprehension of cancer, has seen substantial advancement over the past decade. While the literature has made significant strides in molecular biology and diagnostic criteria, there is room for improvement in achieving a consensus on terminology. This review, which could potentially revolutionize your practice, aims to offer an in-depth understanding of essential criteria, the intricacies involved in diagnosing sessile serrated lesion (SSL) and SSL with dysplasia, the two entities of utmost clinical importance, and the ongoing discussions related to terminology.
