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World J Gastroenterol. Aug 7, 2018; 24(29): 3250-3259
Published online Aug 7, 2018. doi: 10.3748/wjg.v24.i29.3250
Endoscopic diagnosis of sessile serrated adenoma/polyp with and without dysplasia/carcinoma
Takashi Murakami, Naoto Sakamoto, Akihito Nagahara
Takashi Murakami, Naoto Sakamoto, Akihito Nagahara, Department of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
Author contributions: Murakami T mainly contributed to this work, generated the figures and wrote the manuscript; Sakamoto N and Nagahara A contributed equally to the writing of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: 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/
Correspondence to: Takashi Murakami, MD, PhD, Assistant Professor, Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. t-murakm@juntendo.ac.jp
Telephone: +81-3-38133111 Fax: +81-3-38138862
Received: April 2, 2018
Peer-review started: April 3, 2018
First decision: May 30, 2018
Revised: June 27, 2018
Accepted: June 28, 2018
Article in press: June 28, 2018
Published online: August 7, 2018
Core Tip

Core tip: The endoscopic features of sessile serrated adenoma/polyps (SSA/Ps) with and without dysplasia/carcinoma are reviewed. Conventional endoscopic characteristics, including a proximal location, a slightly elevated morphology, a pale color, and a mucus cap, are useful for diagnosing SSA/Ps. Magnifying narrow-band imaging, which detects dark spots inside the crypts and varicose microvascular vessels, and magnifying chromoendoscopy, which identifies the type II-open pit pattern, are also effective for differentiating between SSA/Ps and hyperplastic polyps. Furthermore, the lesions’ endoscopic characteristics, which include their (semi)pedunculated morphologies, double elevations, central depressions, and reddishness, and the use of magnifying endoscopy, might help to detect dysplasia/carcinoma within SSA/Ps.