Of Open Pits and Valleys: Endoscopic Optical Diagnosis Juxtaposition of Pathologically Distinct Rectal Polyp Lesions

Optical diagnosis during colorectal cancer screening is instrumental in deciding whether or not to resect colorectal lesions, choose the appropriate technique and to properly communicate with the pathologist. The latter is even more important when it comes to serrated lesions with the latest WHO classification justifying a pathology diagnosis of a serrated lesion with a minimum criterion of characteristic findings in just one crypt, which may only be detectable when adequate sectioning and scrutinization is performed. Here, we present a unique case of comparatively small rectal lesions with typical endoscopic findings warranting a diagnosis of a serrated lesion (open pit pattern) and adenoma (valley sign).