Management of Serrated Lesions of the Colon and Rectum:Diagnostic Endoscopy for Concurrent Cancer Lesions Hiroshi Kawano 1 , Osamu Tsuruta 2,3 , Shin Hasegawa 2 , Tetsuhiro Noda 2 , Yasuhiko Maeyama 2 , Shuichiro Nagata 2 , Keiichi Mitsuyama 2 , Takuji Torimura 2 1Division of Gastroenterology, St Mary's Hospital, Kurume, Japan 2Division of Gastroenterology, Department of Medicine, Kurume University, Kurume, Japan 3Division of Endoscopy, Kurume University Hospital, Kurume, Japan Keyword: 大腸鋸歯状病変(serrated lesion) , 広基性鋸歯状病変(SSA/P) , 大腸癌(colorectal carcinoma) , NBI , pit pattern pp.1677-1686
Published Date 2015/12/25
DOI https://doi.org/10.11477/mf.1403200492
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 The recently proposed oncogenic pathway in colorectal lesions with serrated structures, i.e., the serrated pathway, has drawn attention to the serrated lesions of the colon and rectum. However, management of such lesions remains controversial. In the present study, to clarify how they should be managed, we examined endoscopic findings and histopathologic findings of hyperplastic lesions, sessile serrated lesions, and classic serrated adenoma. As a result, in the event that normal endoscopy shows reddening, pitting, and two-tiered rounded protuberances; narrow band imaging magnification shows capillary pattern type III ; or pit pattern magnification shows pit pattern type V, concurrent cancer is strongly suspected, and the lesion should be actively resected.

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