Colonic Polyps Flashcards
Polyp
Classified by
protuberance in colonic lumen, flat
neoplastic/non
Benign types
Hyperplastic
Mucosal
Inflam (pseudo)
Hamartomas
Common- normal cells, serrated, small, R/S
Small, normal mucosa
Irregular, mucosal ulcerations & regen
typical in IBD
Overgrowth of normal glands/SM
Hamartomas
Juvenile
Peutx Jeghers
Sporadic
dilated cystic glands, ulcers inflam
glandular epithelium, prol LP and SM
inc risk of malig
Peutz Jeghers Syndrome
Inheritance
Characterized by
Mutation in
Polyps found in`
presentation
AD
hamartomas of GI tract, mucocutaneous pigmentation, inc risk of ca
STK11 (TS)- second hit in 2nd decade
1st decade, SI>colon>stomahc
intussception, SBO, bleeding
Mucocutaneous pigmented mcules
looks like
Common GI cancers
deposit pigment-laden macros in dermis (lips/perioral/buccal mucosa/palms/soles)
Flat/blue-gray-brown
CRC, Gastric, SI, Panc
Juvenile Polypsos
inheritance
Gene defects
Presentation
GI cancers
Suspect in
AD
SMAD4, BMPR1A (TGF B)
lots of polyps in 1st decade, colon mostly- bleeding/Fe def anemia/diarrhea
CRC, gastric
5+ juveline polyps in colon, or stomach/SI
Neoplastic ademoas
Sessile/serrated/Ademoas/polyps (SSA/SSP)
Tubular
Villous
Tubulovillous
Proximal colon, serrated, crypt dilation
MC, pedunculated, round tubular glands, pseudostratified, inc nuclear-cytoplasm ration
Large, sessile w finger like papillae
Variable, both T/V comp
Serated polyps
malignant potential
Epigenentic alterations
advanced adenoma
variable, more so w large/hyperplastic (remove)
hypermethylation of MLH1/MSH2 silence gene expression
high grade dysplasia, large, viollous (higher risk)
Mx
Juvenile
Adenomatous polyps
Repeat
remove
benign, inc risk of bleeding
eradication to prevent against CRC
colonoscopy necessary
No polyp, small, hyperplastic
3-10 tubular ads
Large ubular ads
Villous
SSP <1cm
SSP >1cm
screenings
10 yrs
3yrs
3yrs
3 yrs
5 yrs
3 yrs
