Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 20: A 58-Year-Old Female Underwent A Screening Colonoscopy That Showed A 2.5-Cm Flat Polyp In The Proximal Ascending Colon. I Tattooed The Area And Biopsied The Polyp, Which Was Initially Reported As Hyperplastic. What Should I Do? (continued)

Farzan Fahrtash Bahin, MBBS (Hons); Michael Bourke, MBBS, FRACP

Large, flat proximal colonic lesions are usually not hyperplastic. Serrated lesions (SL) are being increasingly recognized as lesions with a significant premalignant potential. Due to their flat and inconspicuous appearance, they can be difficult to detect. We will describe herein the significance of large serrated lesions and an approach to safe and effective endoscopic treatment. The polyp described is most likely an SL. Large, flat polyps > 10 mm in the proximal colon with histological features suggestive of a hyperplastic polyp (HP) are usually SLs. If a large, proximal colonic…
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