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Intestinal Polyps and Polyposis pp 39–46Cite as

Serrated Neoplasia Pathway

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Abstract

Epithelial serration, namely the saw-toothed outline derived from infolded epithelial tufts in the Lieberkühn’s crypt, typically features hyperplastic polyps of the large bowel as a result of inhibition of the apoptotic homeostatic control. Dysplasia can affect the serrated epithelium of hyperplastic polyps, featuring right-sided colonic neoplastic polyps, the serrated adenomas. Whereas the diagnosis of sessile serrated adenomas is based mainly on architectural dysplasia, cytologic and nuclear dysplasia define traditional (polypoid) serrated adenomas. In mixed serrated polyps, both tubular or tubulo-villous and serrated adenomatous tissue can be seen, indicating the fusion of the classical adenoma-carcinoma sequence with the serrated pathway. Activating mutation of the BRAF gene is the triggering event, and the CpG islands methylator phenotype is the molecular genetic mechanism driving serrated tumorigenesis. Serrated adenomas are potentially evolving neoplastic lesions, maximally in hyperplastic polyposis, and need to be histologically classified and appropriately managed.

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Authors and Affiliations

  1. Unit of Pathology, Institute for Cancer Research and Treatment (IRCC), Turin, Italy

    Mauro Risio MD (Director)

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  1. Mauro Risio MD
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Editors and Affiliations

  1. Department of Surgery and Gastroenterology, University of Verona, Verona, Italy

    Gian Gaetano Delaini

  2. Department of Surgery, Masaryk Memorial Cancer Institute, Brno, Czech Republic

    Tomáš Skřička

  3. Department of Surgery and Gastroenterology, University of Verona, Verona, Italy

    Gianluca Colucci

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© 2009 Springer-Verlag Italia

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Risio, M. (2009). Serrated Neoplasia Pathway. In: Delaini, G.G., Skřička, T., Colucci, G. (eds) Intestinal Polyps and Polyposis. Springer, Milano. https://doi.org/10.1007/978-88-470-1124-3_3

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  • DOI: https://doi.org/10.1007/978-88-470-1124-3_3

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1123-6

  • Online ISBN: 978-88-470-1124-3

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