Open AccessSerrated polyposis syndrome with multiple inverted lesions in the colon: Case report and elucidation of morphogenetic mechanism
Author(s) -
Yoshikawa Chihiro,
Koyama Fumikazu,
Morita Kohei,
Kuge Hiroyuki,
Nakamoto Takayuki,
Obara Shinsaku,
Iwasa Yosuke,
Kunishige Tomohiro,
Ohbayashi Chiho,
Sho Masayuki
Publication year - 2022
Publication title -
den open
Language(s) - English
Resource type - Journals
ISSN - 2692-4609
DOI - 10.1002/deo2.13
Subject(s) - crypt , colonoscopy , medicine , colorectal cancer , morphogenesis , anatomy , cancer , pathology , biology , biochemistry , gene
A 70‐year‐old man underwent surveillance colonoscopy following surgery for occlusive sigmoid colon cancer. The procedure revealed nine sessile serrated lesions (SSLs), including three inverted lesions. Endoscopic and surgical resections were performed. All nine lesions were confirmed pathologically as SSL, and the patient was diagnosed with serrated polyposis syndrome (SPS). Three inverted SSLs (iSSLs) showed endophytic growth without epithelial misplacement. Crypt analysis revealed that iSSL crypts were wider at the bottom than the opening, roughly resembling a frustoconical shape. Our results suggest that a horizontal arrangement of frustoconical crypts leads to hemispherical deformation of the muscularis mucosa, forming an inverted shape. This is the first report to reveal the morphogenesis of iSSLs from the shape of the crypt.