December 2016 Quiz 2

Q2: Answer: B

Rationale: This patient has a sessile serrated polyp without dysplasia located in the right colon as well as hyperplastic polyps in the rectosigmoid. Serrated polyps are thought to be precursor lesions to colon cancers arising from gene hypermethylation. Serrated polyps may be difficult to detect as they are flat or sessile, have indiscrete borders, and adherent mucus. Recent guidelines from the Multi-Society Task Force recommend that these lesions be treated in a way similar to that of adenomas for surveillance. Serrated polyps less than 10 mm without dysplasia should be surveyed in 5 years. Serrated polyps greater than 10 mm with or without dysplasia should be managed in a way similar to that of high-risk adenomas, with surveillance in 3 years. Hyperplastic polyps in the rectum do not require intensified surveillance.

Reference

1. Lieberman, D.A., Rex, D.K., Winawer, S.J., et al. Guidelines for colonoscopy surveillance after screening and polypectomy: A consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012;143:844.

Q2: Answer: B

Rationale: This patient has a sessile serrated polyp without dysplasia located in the right colon as well as hyperplastic polyps in the rectosigmoid. Serrated polyps are thought to be precursor lesions to colon cancers arising from gene hypermethylation. Serrated polyps may be difficult to detect as they are flat or sessile, have indiscrete borders, and adherent mucus. Recent guidelines from the Multi-Society Task Force recommend that these lesions be treated in a way similar to that of adenomas for surveillance. Serrated polyps less than 10 mm without dysplasia should be surveyed in 5 years. Serrated polyps greater than 10 mm with or without dysplasia should be managed in a way similar to that of high-risk adenomas, with surveillance in 3 years. Hyperplastic polyps in the rectum do not require intensified surveillance.

Reference

1. Lieberman, D.A., Rex, D.K., Winawer, S.J., et al. Guidelines for colonoscopy surveillance after screening and polypectomy: A consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012;143:844.

Q2: Answer: B

Rationale: This patient has a sessile serrated polyp without dysplasia located in the right colon as well as hyperplastic polyps in the rectosigmoid. Serrated polyps are thought to be precursor lesions to colon cancers arising from gene hypermethylation. Serrated polyps may be difficult to detect as they are flat or sessile, have indiscrete borders, and adherent mucus. Recent guidelines from the Multi-Society Task Force recommend that these lesions be treated in a way similar to that of adenomas for surveillance. Serrated polyps less than 10 mm without dysplasia should be surveyed in 5 years. Serrated polyps greater than 10 mm with or without dysplasia should be managed in a way similar to that of high-risk adenomas, with surveillance in 3 years. Hyperplastic polyps in the rectum do not require intensified surveillance.

Reference

1. Lieberman, D.A., Rex, D.K., Winawer, S.J., et al. Guidelines for colonoscopy surveillance after screening and polypectomy: A consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012;143:844.