One polyp or two polyps?
This is an interesting looking colonic polyp
WHAT IS THE LIKELY HISTOLOGY
a) mixed serrated / adenomatous polyp
And that is what it looks like!!!
b) traditional serrated adenoma
But there are TWO components to this polyp!
c) serrated polyp undergoing malignant conversion
Well something has happened but 'lesion' has beautiful crypts!
Actually, the red bit of the polyp was composed of a tubulovillous adenoma and the rest was a serrated polyp! In other words, a mixed serrated/adenomatous polyp. Clearly the famous "three pathways to colorectal cancer": the APC mutation pathway (50%-70%); the mutator “Lynch syndrome” route (3%-5%); and the serrated pathway (30%-35%) can sometime get mixed up !!!