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Pathogenesis of Serrated Adenoma of the Colorectum: Implication for Malignant Progression

  • Chapter
Molecular Pathology of Gastroenterological Cancer

Summary

Hyperplastic polyps of the colorectum are known to show dysplastic changes and may be mixed hyperplastic adenomatous polyps. It is proposed that these polyps are serrated adenomas and represent a morphologically unique variant of adenoma. The serrated adenoma, characteristically containing proliferative activity in the lower portion of the crypts. is distinctly different from ordinary adenomas, which are found in the upper portion of the crypts. In proliferative lesions of the crypts, abnormal accumulation of P53 protein is frequently associated with serrated adenomas that display severe dysplasia and microinvasive serrated adenocarcinomas, regarded as hyperplastic polyps with pseudoinvasive glands. Some of the superficial-type serrated adenocarcinomas arising from serrated adenomas or hyperplastic polyps are small and display aggressive behavior, manifesting as liver metastasis. The changes found in both hyperplastic polyps and carcinoma—including increased secretion of carcinoembryonic antigen, altered blood antigen expression, and reduced secretion of sialomucin—which were found in hyperplastic polyps, cannot explained unless serrated adenomas arising in hyperplastic polyps are recognized as true neoplasia. Here we describe the relations among hyperplastic nodules, hyperplastic polyps, serrated adenomas, and traditional carcinomas with the hope of understanding this distinct neoplastic lesion of the colorectum. Recent data are reviewed.

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Authors and Affiliations

  1. Department of Pathology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734, Japan

    Fumio Shimamoto

  2. First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minamiku, Hiroshima 734, Japan

    Shinji Tanaka

  3. First Department of Pathology, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734, Japan

    Eiichi Tahara

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  1. Fumio Shimamoto
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  2. Shinji Tanaka
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  3. Eiichi Tahara
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Editors and Affiliations

  1. Faculty of Medicine, First Department of Pathology, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734, Japan

    Eiichi Tahara M.D., Ph.D. (Director, Professor and Chairman) (Director, Professor and Chairman)

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© 1997 Springer Japan

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Shimamoto, F., Tanaka, S., Tahara, E. (1997). Pathogenesis of Serrated Adenoma of the Colorectum: Implication for Malignant Progression. In: Tahara, E. (eds) Molecular Pathology of Gastroenterological Cancer. Springer, Tokyo. https://doi.org/10.1007/978-4-431-65915-0_9

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  • DOI: https://doi.org/10.1007/978-4-431-65915-0_9

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