Pedunculated
A shape description: the polyp grows on a stalk. Shape does not by itself tell you the pathology.
Polyps explained
Not every colon polyp means the same thing.
Most polyps are not cancer. Some types can be precancerous, and the future plan depends on more than the name alone.
Sessile
A broad-based or flatter shape without a long stalk. “Sessile” describes shape; “sessile serrated lesion” is a specific pathology diagnosis.
Flat lesion
Some lesions are subtle and rise only slightly above the lining, which is one reason bowel-prep and inspection quality matter.
Common pathology families
What the microscope may show
Conventional adenoma
Includes tubular, tubulovillous, and villous adenomas. These are precancerous polyps, but an adenoma is not the same as cancer.
Sessile serrated lesion
A serrated precancerous lesion, often subtle and sometimes found in the proximal/right colon.
Traditional serrated adenoma
A less common serrated precancerous lesion that generally affects surveillance planning.
Hyperplastic polyp
Many small distal hyperplastic polyps have very low malignant potential, although size, location, number, and pathology certainty matter.
Five details that change the conversation
The polyp name is only one piece.
- Number: one small lesion is different from multiple lesions.
- Size: size can alter risk classification and follow-up.
- Histology: adenomatous, serrated, dysplasia, and other microscopic features matter.
- Removal: complete en-bloc removal versus piecemeal removal may matter, especially for larger lesions.
- Exam quality: inadequate prep or an incomplete exam can change what happens next.
Evidence
Primary sources for this page
ACGColon polyps patient informationASGEPolyps and their treatmentAGA / USMSTF2020 post-polypectomy follow-up guidance
Medical content reviewed against these sources on September 5, 2026. External clinician review is still recommended before broad public promotion.