Serrated Polyposis of the Colon and Rectum
Differential Diagnosis
- Familial adenomatous polyposis
- Hereditary non-polyposis colorectal cancer
- Juvenile polyposis
- Hereditary mixed polyposis
| Serrated Polyposis (Hyperplastic Polyposis) | Familial Adenomatous Polyposis |
Multiple serrated polyps with at most focal cytologic dysplasia |
Multiple adenomatous polyps, all with cytologic dysplasia |
| Serrated Polyposis (Hyperplastic Polyposis) | Hereditary Nonpolyposis Colorectal Cancer |
| Multiple serrated polyps (most are SSA) | Polyps are not increased |
| Not associated with extra-GI cancers | Associated with carcinomas of the endometrium, small intestine, ureter and renal pelvis |
| Associated with sporadic, non-familial colorectal adenocarcinoma | Familial colorectal adenocarcinoma and other neoplasms |
| Juvenile Polyposis | Serrated Polyposis (Hyperplastic Polyposis) |
| Polypoid | Sessile |
| Prominent cystically dilated glands | Cystic dilation not prominent |
| Irregular glands | Glands are vertically arranged and not complex |
| Prominent inflamed stroma | Stroma is not prominent |
| Serrated Polyposis (Hyperplastic Polyposis) | Hereditary Mixed Polyposis |
| Adenomatous cytologic features infrequent, focal at most | Most polyps are adenomatous, either pure or mixed |
| Most polyps are sessile | Most are polypoid, regardless of histology |
| Glands are vertically arranged and not complex | Frequently shows features of juvenile polyps: prominent stroma, cystic dilation |
