Among polypoid laesions of the large bowel the great attention should be payed to Adenomas because of they neoplastic transformation capabilities. In this paper a classification of neoplastic adenomas extended with serrated adenoma and hyperplastic polyps with presence of tubular adenoma structures has been presented. The recommended laboratory procedures used in preparing of endoscopy material has been discussed. The role of Pathologists and Gastrologist in proper diagnosis of precancerous and early cancerous changes has been also discussed.