(A), Small (8-mm diameter) conventional adenoma. The red lines are surface blood vessels.
(B), A portion of a 40-mm advanced conventional adenoma — one of the targets of all
screening tests. The prominent blood vessel pattern is, again, visible.
(C), A conventional adenoma with a focus of invasive cancer. The prominent blood vessel
pattern of a conventional adenoma is visible over the lesion except in the ulcerated area.
The cancer is located at the ulcer (arrows).
(D), A sessile serrated polyp without cytologic dysplasia. Note the absence of blood vessels
on the surface.
(E), A sessile serrated polyp (visualized in narrow-band imaging ) with multiple foci of
cytologic dysplasia (yellow arrows). The dysplastic areas have the blood vessel pattern (and
the histologic features) of an adenoma. The white arrows point to non-dysplastic portions
of this sessile serrated polyp.
(F), A sessile serrated polyp with invasive cancer. White arrows designate the residual
sessile serrated polyp, whereas yellow arrows indicate the ulcerated malignant portion of
the lesion.
Figure 1. Endoscopic Photographs of Conventional Adenomas and
Sessile Serrated Polyps
