The Serrated Polyp Comes of Age

Classification of serrated polyps. (A) Hyperplastic polyp, microvesicular type. The serration is noted in the upper half of the mucosa. Goblet cells are scant. Most of the mucin is present in vesicular cells. (B) Hyperplastic polyp, goblet cell type. Serration is limited. Mucin is abundant and present in prominent goblet cells. (C) Hyperplastic polyp, mucin-poor type. The serration is prominent. Almost no mucin is observed. (D) Traditional serrated adenoma. This polyp has a characteristic villiform configuration. The epithelium is composed of tall columnar cells with eosinophilic cytoplasm and hyperchromatic, pencillate nuclei. (E) Endoscopic image of a sessile serrated adenoma in the transverse colon. Note the pale appearance and flat growth pattern. (F) Sessile serrated adenoma. This polyp is characterized by distention and branching of the crypts. Note the dilation and anchor-shaped pattern of growth of the bases of some crypts.