Caros amigos do FORO, neste caso de polipo retal, parece estar ocorrendo uma dificuldade com conceitos.
Polipo serrilhado(serrate polyps)não é a mesma coisa que adenoma serrilhado(serrate adenoma).
O primeiro(POLIPO), é lesão de difícil e confusa caracterização, não apresenta displasia, nem evidente potencial de malignidade.
O segundo(ADENOMA)por definição conceitual, tem displasia epitelial e eventual potencialidade de transformação em carcinoma.
Revejam o texto enviado pelo Caro confrade Clovis:
Serrated Colorectal Polyps: An Update.
Pathology Case Reviews. 9(4):173-182, July/August 2004.
Batts, Kenneth P. MD
Traditionally, hyperplastic polyps of the colon and rectum have been recognized morphologically by the hallmarks of a serrated architecture and a lack of dysplasia and have been regarded as benign, nonneoplastic epithelial proliferations.
Polyps with a serrated architecture but also epithelial dysplasia have been termed "serrated adenomas." Evidence from both morphologic and molecular perspectives has forced a reevaluation of traditional thought about the classification of colorectal polyps with a serrated architecture.
Among polyps traditionally called hyperplastic polyps, there is evidence suggesting that a polyp termed "sessile serrated adenoma" by some could demonstrate preneoplastic risk by means of hypermethylation of tumor-suppressor genes. Furthermore, it appears that many polyps with admixed areas of hyperplastic and adenomatous polyps could represent dysplastic transition of the serrated component rather than collisions of unrelated polyps.
There is also evidence that serrated polyps with dysplasia ("traditional serrated adenomas") could be more closely linked to other serrated polyps than usual adenomas. "Hyperplastic polyposis" syndromes tend to be associated with preneoplastic potential and are most commonly composed of multiple "sessile" serrated adenomas, but might not be a homogeneous group.
In summary, serrated colorectal polyps are likely a more heterogeneous group than previously thought, contains at least some subsets that appear to have preneoplastic potential (aqui os adenomas serrilhados), and there is a link between serrated polyps and hypermethylation.
Our understanding of this family of polyps is still evolving and questions remain about the natural history of these polyps, the ability of pathologists to accurately recognize the various forms of serrated colorectal polyps morphologically, and the optimal treatment and follow up for these polyps.