title: Confocal laser endomicroscopy features of sessile serrated adenomas/polyps.
abstract: OBJECTIVE
  Sessile serrated adenomas/polyps (SSA/Ps) are difficult to differentiate from non-neoplastic tissue on white-light endoscopy. Confocal laser endomicroscopy (CLE) provides subcellular imaging and real-time "optical biopsy". The aim of this study was to prospectively describe CLE features of SSA/Ps.
  
  
  METHODS
  Consecutive patients with SSA/Ps were prospectively evaluated with probe-based CLE imaging. CLE images and polyp histology were independently reviewed by three endoscopists and an expert gastrointestinal (GI) pathologist. Distinguishing CLE features of SSA/Ps were identified in conjunction with pathologic correlation.
  
  
  RESULTS
  In total, 260 CLE images were generated from nine SSA/Ps evaluated in seven patients. Four consensus CLE features of SSA/P were identified: (1) a mucus cap with a bright, cloud-like appearance; (2) thin, branching crypts; (3) increased number of goblet cells and microvesicular mucin-containing cells; and (4) architectural disarray, with dystrophic goblet cells and lack of regular circular crypts.
  
  
  CONCLUSIONS
  This is a novel description of characteristic CLE features of SSA/Ps. The four features we identified are easy to detect and may allow for CLE to serve as a diagnostic modality.
authors.affiliation: Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Neil D
authors.initials: ND
authors.lastname: Parikh
authors.affiliation: Department of Pathology, Yale University School of Medicine, New Haven CT, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Gibson
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Anil
authors.initials: A
authors.lastname: Nagar
authors.affiliation: Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Ahmed
authors.affiliation: Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Harry R
authors.initials: HR
authors.lastname: Aslanian
keywords: Confocal laser endomicroscopy; optical biopsy; sessile serrated adenoma/polyp