Nasim Parsa, MD, Douglas K. Rex, MD VideoGIE

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Presentation transcript:

Endoscopic recognition of the sessile serrated polyp to cancer sequence Nasim Parsa, MD, Douglas K. Rex, MD VideoGIE Volume 2, Issue 7, Pages 185-187 (July 2017) DOI: 10.1016/j.vgie.2017.04.004 Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A sessile serrated polyp immediately before submucosal injection demonstrating pale color, indiscrete edges, and absence of surface vessels. VideoGIE 2017 2, 185-187DOI: (10.1016/j.vgie.2017.04.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 The same sessile serrated polyp during submucosal injection with a contrast agent. Arrows indicate the now clearly demonstrated margin of the lesion. VideoGIE 2017 2, 185-187DOI: (10.1016/j.vgie.2017.04.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 A sessile serrated polyp without cytologic dysplasia. Red arrows point to the indiscrete edges. Black arrows point to the cloudlike surface. Yellow arrows point to the rare blood vessels. VideoGIE 2017 2, 185-187DOI: (10.1016/j.vgie.2017.04.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 A sessile serrated polyp with cytologic dysplasia. The yellow line surrounds the dysplastic portion. VideoGIE 2017 2, 185-187DOI: (10.1016/j.vgie.2017.04.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 A sessile serrated polyp (SSP) with cytologic dysplasia. The red arrows delineate the margin of SSP. The blue arrows delineate the margin of dysplastic region, which has endoscopic features of a conventional adenoma. Note the adherent yellow mucus cap on the SSP portion. VideoGIE 2017 2, 185-187DOI: (10.1016/j.vgie.2017.04.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 The same lesion seen in Figure 5 is now demonstrated in narrow-band imaging (NBI) and close focus (magnified view). The blue line delineates the margin of dysplastic focus. The red arrows point to portions of the mucus cap on sessile serrated polyp (SSP), which appears pink in NBI. VideoGIE 2017 2, 185-187DOI: (10.1016/j.vgie.2017.04.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 7 Cancer (yellow arrows) arising in a sessile serrated polyp (SSP). The benign SSP portion is to the left of the black line. VideoGIE 2017 2, 185-187DOI: (10.1016/j.vgie.2017.04.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions