Usefulness of analyzing endoscopic features in identifying the colorectal serrated sessile lesions with and without dysplasia

Figure 1 Colorectal sessile serrated lesions characterized by colonoscopy demonstrate. A: White light endoscopy of the sessile serrated lesion (SSL) surface covered with mucus cap; B: White light endoscopy of the SSL with pale color and cloud-like surface; C: White light endoscopy of the SSL-dysplasia (SSL-D) against a pale color background with localized reddish mucosa and a depression visible in the center of the cloud-like surface; D: In the endoscopic blue laser imaging (BLI) mode, the dilated crypt of the SSL appears as black spots (as shown by the arrow); E: In the endoscopic magnified BLI mode, microvascular varicose is visible on the surface of the SSL-D (as shown by arrows); F: In endoscopic magnified BLI mode, the dilated crypt of the SSL-D appears as Pit IIIL type in the background of Pit II-O.

Figure 2 Histopathological demonstration of colorectal the sessile serrated lesion and sessile serrated lesion-dysplasia (hematoxylin and eosin, objective magnifications 20 ×, 3DHISTECH). A: The crypt has at least one of the following histologic features: (1) Horizontal growth along the mucosal muscle layer (L or inverted T-shaped crypt structure); (2) Expansion of the crypt base (basal 1/3 of the crypt base); (3) Jagged swelling of the crypt base; and (4) Asymmetric hyperplasia (proliferative band extending laterally from the base); B: Complex structural abnormalities, including: (1) Crypt elongation, crowding, complex branching, sieve-like structures, and villi-like structures; and (2) Cytologic abnormalities of diverse morphology, either with cuboidal cells, eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli, or with elongated cells, eosinophilic cytoplasm, deep-stained nuclei, and pseudostratified nuclei, with common nuclear schizophrenic signs.