Colorectal Polyps (1*)

Question 1

What are its 2 types?

Can it be cancerous or not?

Answer 1

➊ • Pedunculated - attached to mucosa by a stalk
• Sessile - attached to mucosa by a broad base

➋ May be benign (hyperplastic polyp), premalignant (adenomas), or malignant

Question 2

What are inflammatory polyps associated with?

Which conditions are hamartomatous polyps associated with?

Why do adenomatous polyps (adenomas) form?
→ How does it relate to an adenocarcinoma?
→ What increases the risk of it progressing to a ca.?

Answer 2

➊ Episodes of IBD

➋ Juvenile Polyposis and Peutz-Jeghers Syndrome

➌ Due to mutations and inactivation of the TSG, Adenomatous Polyposis Coli gene (APC)
→ Pre-malignant condition
→ • Large in size
• Villous type on histology
• High-grade dysplasia

Question 3

How does it present?

How is it investigated and managed?

What are its complications?

Answer 3

➊ Mostly asymptomatic, but may present with PR bleeding (leading to anaemia symptoms), and a change in bowel habits

➋ Colonoscopy/Flexible sigmoidoscopy to see polyp and remove it

➌ • Ulceration and bleeding
• Obstruction if large enough - presents with abdo pain and constipation