Non-neoplastic polyps

Question 1

When do inflammatory polyps form? What causes it?

Answer 1

Solitary rectal ulcer syndrome

Impaired relaxation of anorectal sphincter, sharp angle at anterior rectal shelf, abrasions of rectal mucosa.

Question 2

Discuss Juvenile Polyps

Answer 2

AD, SMAD4 and BMPR1A. Solitary, usually in the rectum. A type of Hamartomatous polyp

Question 3

What are the clinical features of a Juvenile polyp?

Answer 3

Painless bleeding after defecation, prolapse through anal sphincter.

Question 4

Discuss the morphology of a juvenile polyp

Answer 4

Macro: Pedunculated polyp with red surface and cystic spaces on cut sections.
Micro: normal base mucosa, mucus filled cysts.

Question 5

Discuss Peutz-Jeghers Syndrome

Answer 5

Hamartomatous polyp, LKB1/STK11 AD, commonly found in small bowel.

Question 6

Discuss the morphology of Peutz-Jeghers Syndrome

Answer 6

Macro: Large pedunculated polyps w/ lobulated contour

Also associated with pigmentation of mucous membranes

Question 7

Discuss Cowden and BRR syndromes

Answer 7

AD, PTEN, hamartomatous polyps, lipomas, MACROCEPHALY and pigmented macules on GLANS PENIS

Question 8

How do you distinguish Cowden syndrome from BRR syndrome?

Answer 8

Cowden syndrome has no increased risk of GI malignancy but an increase in breast cancer.
BRR syndrome pts will also show mental deficiencies and developmental delays.

Question 9

Discuss Cronkite-Canada Syndrome

Answer 9

NONHEREDITARY; Look like juvinile polyps but in stomach/small bowel. Associated with nail atrophy and hair loss

Question 10

Discuss Hyperplastic Polyps

Answer 10

No malignant potential, Found in left colon, Pile up of goblet cells, looks like sessile serrated adenomas,