Chapter 47: Colon and Rectum- Colonic and Rectal Polyps Flashcards
What are they?
Tissue growth into bowel lumen, usually consisting of mucosa, submucosa, or both
How are they anatomically classified?
- Sessile (flat)
- Pedunculated (on a stalk)
What are the histologic classifications of the following types:
Inflammatory (pseudopolyp)?
As in Crohn’s disease or ulcerative colitis
What are the histologic classifications of the following types:
Hamartomatous?
Normal tissue in abnormal configuration
What are the histologic classifications of the following types:
Hyperplastic?
Benign—normal cells—no malignant potential
What are the histologic classifications of the following types:
Neoplastic?
Proliferation of undifferentiated cells; premalignant or malignant cells
What are the subtypes of neoplastic polyps?
- Tubular adenomas (usually pedunculated)
- Tubulovillous adenomas
- Villous adenomas (usually sessile and look like broccoli heads)
What determines malignant potential of an adenomatous polyp?
- Size
- Histologic type
- Atypia of cells
What is the correlation between size and malignancy?
Polyps >2 cm have a high risk of carcinoma (33% to 55%)
What about histology and cancer potential of an adenomatous polyp?
Villous > tubovillous > tubular
(Think: VILLous = VILLain)
What is the approximate percentage of carcinomas found in the following polyps overall:
Tubular adenoma?
5%
What is the approximate percentage of carcinomas found in the following polyps overall:
Tubulovillous adenoma?
20%
What is the approximate percentage of carcinomas found in the following polyps overall:
Villous adenoma?
40%
Where are most polyps found?
Rectosigmoid (30%)
What are the signs/symptoms?
- Bleeding (red or dark blood)
- change in bowel habits
- mucus per rectum
- electrolyte loss
- totally asymptomatic
