COLORECTAL POLYPS

Question 1

Morphological subtypes (2)

Answer 1

1- Sessile (flat)
2- Pedunculated (on a stalk)

Question 2

Histological types: (5)

Answer 2

1- Inflammatory: pseudopolyp seen in UC
2- Hyperplastic: overgrowth of normal tissue, benign epithelial dysplasia, no malignant potential, common in elderly
3- Serrated: pre-malignant
4- Adenomatous: pre-malignant
-Villous: 40% risk of cancer
- Tubulovillous: 20% risk of cancer
- Tubular: most common, 5% risk of cancer
- Hamartamous: Normal tissue in abnormal configuration e.g. juvenile polyps, peutz-jeghers polyps

Question 3

Signs and symptoms (5)

Answer 3

1- Asymptomatic (most common)
2- Melena, hematochezia, occult bleeding
3- Obstruction
4- Mucus
5- Change in bowel habits (e.g. secretory diarrhea)

Question 4

Risk of cancer is high when?

Answer 4

A polyp is >2cm, villious, severe atypia

Question 5

Treatment

Answer 5

Colonoscopic resection, follow-up surveillance colonoscopy for adenomatous polyp:
- >2cm , >2 polyps, villous component on histopathology —> 3 years
- <2cm, 1 or 2 polyps, tubular histology —> 5 years