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Even though serrated polyps with stromal changes can be challenging, up to 67.7% of them could be readily classified as SSP or HP. The remaining unclassifiable serrated polyps with stromal changes may represent a heterogeneous group. Prolapse changes support the diagnosis of HP while basal crypt distortion in more than one crypt supports the diagnosis of SSP.

Colorectal Serrated Polyp With Stromal Changes: An Interobserver Agreement Study