Traditional serrated adenoma: Difference between revisions
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{{Infobox medical condition | |||
| name = Traditional serrated adenoma | |||
| image = [[File:Traditional_serrated_adenoma_intermed_mag.jpg|left|thumb|Traditional serrated adenoma under intermediate magnification]] | |||
| caption = Histological image of a traditional serrated adenoma | |||
| field = [[Gastroenterology]], [[Pathology]] | |||
| synonyms = TSA | |||
| symptoms = Often asymptomatic, may present with [[rectal bleeding]] | |||
| complications = Potential progression to [[colorectal cancer]] | |||
| onset = Typically in adults over 50 years | |||
| duration = Chronic | |||
| causes = Unknown, associated with [[genetic mutations]] | |||
| risks = [[Family history]] of colorectal cancer, [[smoking]], [[obesity]] | |||
| diagnosis = [[Colonoscopy]] with [[biopsy]] | |||
| differential = [[Hyperplastic polyp]], [[Sessile serrated lesion]] | |||
| prevention = Regular [[screening]] colonoscopies | |||
| treatment = [[Endoscopic polypectomy]] | |||
| prognosis = Generally good if removed early | |||
| frequency = Rare, less than 1% of all [[colorectal polyps]] | |||
}} | |||
== Traditional Serrated Adenoma == | == Traditional Serrated Adenoma == | ||
[[File:Traditional_serrated_adenoma_intermed_mag.jpg|left|thumb|Micrograph of a traditional serrated adenoma.]] | |||
[[File:Traditional_serrated_adenoma_intermed_mag.jpg|thumb | |||
A '''traditional serrated adenoma''' (TSA) is a type of [[colorectal polyp]] that is characterized by its serrated or saw-tooth appearance under the microscope. TSAs are considered precursors to [[colorectal cancer]], particularly when they exhibit dysplastic features. | A '''traditional serrated adenoma''' (TSA) is a type of [[colorectal polyp]] that is characterized by its serrated or saw-tooth appearance under the microscope. TSAs are considered precursors to [[colorectal cancer]], particularly when they exhibit dysplastic features. | ||
== Histology == | == Histology == | ||
Traditional serrated adenomas are distinguished by their unique histological features. They typically display a serrated architecture with elongated crypts and a complex glandular pattern. The epithelial cells often have eosinophilic cytoplasm and may show nuclear atypia. Unlike other serrated lesions, such as [[hyperplastic polyps]] and [[sessile serrated lesions]], TSAs have a more pronounced dysplastic component. | Traditional serrated adenomas are distinguished by their unique histological features. They typically display a serrated architecture with elongated crypts and a complex glandular pattern. The epithelial cells often have eosinophilic cytoplasm and may show nuclear atypia. Unlike other serrated lesions, such as [[hyperplastic polyps]] and [[sessile serrated lesions]], TSAs have a more pronounced dysplastic component. | ||
== Pathogenesis == | == Pathogenesis == | ||
The pathogenesis of traditional serrated adenomas involves genetic and epigenetic alterations. Mutations in the [[BRAF]] gene are commonly associated with TSAs, similar to other serrated pathway lesions. These mutations lead to activation of the [[MAPK/ERK pathway]], promoting cellular proliferation and survival. Additionally, TSAs may exhibit [[CpG island methylator phenotype]] (CIMP), which contributes to their progression to malignancy. | The pathogenesis of traditional serrated adenomas involves genetic and epigenetic alterations. Mutations in the [[BRAF]] gene are commonly associated with TSAs, similar to other serrated pathway lesions. These mutations lead to activation of the [[MAPK/ERK pathway]], promoting cellular proliferation and survival. Additionally, TSAs may exhibit [[CpG island methylator phenotype]] (CIMP), which contributes to their progression to malignancy. | ||
== Clinical Significance == | == Clinical Significance == | ||
Traditional serrated adenomas are clinically significant due to their potential to progress to [[colorectal cancer]]. They are often found in the left colon and rectum, although they can occur throughout the colon. Surveillance and removal of TSAs during [[colonoscopy]] are important to prevent the development of cancer. | Traditional serrated adenomas are clinically significant due to their potential to progress to [[colorectal cancer]]. They are often found in the left colon and rectum, although they can occur throughout the colon. Surveillance and removal of TSAs during [[colonoscopy]] are important to prevent the development of cancer. | ||
== Diagnosis == | == Diagnosis == | ||
The diagnosis of traditional serrated adenoma is primarily based on histological examination of biopsy or resection specimens. Pathologists look for the characteristic serrated architecture and cytological features to distinguish TSAs from other types of polyps. Immunohistochemical staining may be used to support the diagnosis and assess for molecular markers. | The diagnosis of traditional serrated adenoma is primarily based on histological examination of biopsy or resection specimens. Pathologists look for the characteristic serrated architecture and cytological features to distinguish TSAs from other types of polyps. Immunohistochemical staining may be used to support the diagnosis and assess for molecular markers. | ||
== Treatment == | == Treatment == | ||
The primary treatment for traditional serrated adenomas is endoscopic removal. Complete excision is recommended to prevent progression to cancer. Patients with TSAs may require more frequent surveillance colonoscopies to monitor for recurrence or the development of new lesions. | The primary treatment for traditional serrated adenomas is endoscopic removal. Complete excision is recommended to prevent progression to cancer. Patients with TSAs may require more frequent surveillance colonoscopies to monitor for recurrence or the development of new lesions. | ||
== See also == | |||
== | |||
* [[Colorectal cancer]] | * [[Colorectal cancer]] | ||
* [[Colorectal polyp]] | * [[Colorectal polyp]] | ||
* [[Hyperplastic polyp]] | * [[Hyperplastic polyp]] | ||
* [[Sessile serrated lesion]] | * [[Sessile serrated lesion]] | ||
[[Category:Colorectal cancer]] | [[Category:Colorectal cancer]] | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] {{stub}} | ||
Latest revision as of 23:14, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Traditional serrated adenoma | |
|---|---|
 | |
| Synonyms | TSA |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Often asymptomatic, may present with rectal bleeding |
| Complications | Potential progression to colorectal cancer |
| Onset | Typically in adults over 50 years |
| Duration | Chronic |
| Types | N/A |
| Causes | Unknown, associated with genetic mutations |
| Risks | Family history of colorectal cancer, smoking, obesity |
| Diagnosis | Colonoscopy with biopsy |
| Differential diagnosis | Hyperplastic polyp, Sessile serrated lesion |
| Prevention | Regular screening colonoscopies |
| Treatment | Endoscopic polypectomy |
| Medication | N/A |
| Prognosis | Generally good if removed early |
| Frequency | Rare, less than 1% of all colorectal polyps |
| Deaths | N/A |
Traditional Serrated Adenoma[edit]
A traditional serrated adenoma (TSA) is a type of colorectal polyp that is characterized by its serrated or saw-tooth appearance under the microscope. TSAs are considered precursors to colorectal cancer, particularly when they exhibit dysplastic features.
Histology[edit]
Traditional serrated adenomas are distinguished by their unique histological features. They typically display a serrated architecture with elongated crypts and a complex glandular pattern. The epithelial cells often have eosinophilic cytoplasm and may show nuclear atypia. Unlike other serrated lesions, such as hyperplastic polyps and sessile serrated lesions, TSAs have a more pronounced dysplastic component.
Pathogenesis[edit]
The pathogenesis of traditional serrated adenomas involves genetic and epigenetic alterations. Mutations in the BRAF gene are commonly associated with TSAs, similar to other serrated pathway lesions. These mutations lead to activation of the MAPK/ERK pathway, promoting cellular proliferation and survival. Additionally, TSAs may exhibit CpG island methylator phenotype (CIMP), which contributes to their progression to malignancy.
Clinical Significance[edit]
Traditional serrated adenomas are clinically significant due to their potential to progress to colorectal cancer. They are often found in the left colon and rectum, although they can occur throughout the colon. Surveillance and removal of TSAs during colonoscopy are important to prevent the development of cancer.
Diagnosis[edit]
The diagnosis of traditional serrated adenoma is primarily based on histological examination of biopsy or resection specimens. Pathologists look for the characteristic serrated architecture and cytological features to distinguish TSAs from other types of polyps. Immunohistochemical staining may be used to support the diagnosis and assess for molecular markers.
Treatment[edit]
The primary treatment for traditional serrated adenomas is endoscopic removal. Complete excision is recommended to prevent progression to cancer. Patients with TSAs may require more frequent surveillance colonoscopies to monitor for recurrence or the development of new lesions.
See also[edit]
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