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

  • Fumio Shimamoto
  • Shinji Tanaka
  • Eiichi Tahara


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.


Hyperplastic Polyp Aberrant Crypt Focus Serrate Adenoma Serrate Adenocarcinoma Hyperplastic Nodule 
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Copyright information

© Springer Japan 1997

Authors and Affiliations

  • Fumio Shimamoto
    • 1
  • Shinji Tanaka
    • 2
  • Eiichi Tahara
    • 3
  1. 1.Department of PathologyHiroshima University HospitalMinami-ku, Hiroshima 734Japan
  2. 2.First Department of Internal MedicineHiroshima University School of MedicineMinamiku, Hiroshima 734Japan
  3. 3.First Department of PathologyHiroshima University School of MedicineMinami-ku, Hiroshima 734Japan

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