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Colonic Polyps

Updated : April 25, 2024





Background

Colon polyps are protuberances in the colon lumen that can form on their own or as part of a condition.

Polyps are classified in the following manner:

  • Diminutive polyps: Diameter is less than 5mm
  • Small polyps: Diameter is between 6-9mm
  • Large polyps: Diameter is above 1cm

Polyps can be described as depressed, flat, sessile, or pedunculated. Lipomas, carcinoids, and lymphoid aggregates are among the polyps that develop from the submucosa.

They are most usually adenomatous or non-neoplastic, and they can be tubular, villous, or tubulovillous (hyperplastic and juvenile). Hyperplastic polyps are common and have a low risk of becoming cancerous. They’re more common in the distal portion of the colon. The benign hamartomas known as juvenile polyps are very frequent in children.

Epidemiology

The incidence of colorectal polyps rises with age. They’re more prevalent in western countries. In the United States, 30% of adults over the age of 50 have the disease.

However, 6% of children are afflicted, and children who are experiencing lower gastrointestinal bleeding have a higher chance (12%) of being affected by colon polyps. Men who are not Caucasians have a higher risk of developing colon polyps.

Anatomy

Pathophysiology

Polyps have clinical importance since they are responsible for over 95% of colon cancer cases. Sessile serrated polyps are frequent in the proximal colon, and they present low risk of developing into cancer in the dysplasia, but a high malignant potential if dysplastic. Traditional serrated adenoma is rare, it occurs more frequently in the distal colon and carries a high risk of malignancy.

Some examples of non-neoplastic polyps are:

  • Hyperplastic polyps
  • Hamartomas
  • Inflammatory pseudopolyps
  • Juvenile polyps

Hyperplastic polyps are frequent in the distal colon and have a low risk of becoming cancerous. Polyps in children are benign hamartomas that are not cancerous. They are more prevalent in the rectosigmoid in childhood. Polyps become cancerous when tumor suppressor genes like adenomatous polyposis coli or mismatch repair genes such as MLH1 have become inactive.

Familial adenomatous polyposis is autosomal dominant, and most patients with the disease acquire colorectal cancer (CRC) by the age of 40. JPS (juvenile polyposis syndrome) is an autosomal dominant disease. 50-60% of observed patients display a mutation in the BMPR1A or SMAD4 gene. CRC affects 20% of people by the age of 35. Other modes of inheritance exist, such as autosomal recessive MUTYH-associated polyposis (MAP), which is caused due to biallelic mutations in the MUTYH gene.

Etiology

Risk factors for developing colonic polyps are:

  • Older age
  • Male sex
  • Diet high in fat and low in fiber
  • Excessive alcohol consumption
  • Family history of colorectal cancer, intestinal polyposis or polyps

Polyps were found to be less common in people who had inflammatory bowel illness.

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK430761/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139994/

Colonic Polyps

Updated : April 25, 2024




Colon polyps are protuberances in the colon lumen that can form on their own or as part of a condition.

Polyps are classified in the following manner:

  • Diminutive polyps: Diameter is less than 5mm
  • Small polyps: Diameter is between 6-9mm
  • Large polyps: Diameter is above 1cm

Polyps can be described as depressed, flat, sessile, or pedunculated. Lipomas, carcinoids, and lymphoid aggregates are among the polyps that develop from the submucosa.

They are most usually adenomatous or non-neoplastic, and they can be tubular, villous, or tubulovillous (hyperplastic and juvenile). Hyperplastic polyps are common and have a low risk of becoming cancerous. They’re more common in the distal portion of the colon. The benign hamartomas known as juvenile polyps are very frequent in children.

The incidence of colorectal polyps rises with age. They’re more prevalent in western countries. In the United States, 30% of adults over the age of 50 have the disease.

However, 6% of children are afflicted, and children who are experiencing lower gastrointestinal bleeding have a higher chance (12%) of being affected by colon polyps. Men who are not Caucasians have a higher risk of developing colon polyps.

Polyps have clinical importance since they are responsible for over 95% of colon cancer cases. Sessile serrated polyps are frequent in the proximal colon, and they present low risk of developing into cancer in the dysplasia, but a high malignant potential if dysplastic. Traditional serrated adenoma is rare, it occurs more frequently in the distal colon and carries a high risk of malignancy.

Some examples of non-neoplastic polyps are:

  • Hyperplastic polyps
  • Hamartomas
  • Inflammatory pseudopolyps
  • Juvenile polyps

Hyperplastic polyps are frequent in the distal colon and have a low risk of becoming cancerous. Polyps in children are benign hamartomas that are not cancerous. They are more prevalent in the rectosigmoid in childhood. Polyps become cancerous when tumor suppressor genes like adenomatous polyposis coli or mismatch repair genes such as MLH1 have become inactive.

Familial adenomatous polyposis is autosomal dominant, and most patients with the disease acquire colorectal cancer (CRC) by the age of 40. JPS (juvenile polyposis syndrome) is an autosomal dominant disease. 50-60% of observed patients display a mutation in the BMPR1A or SMAD4 gene. CRC affects 20% of people by the age of 35. Other modes of inheritance exist, such as autosomal recessive MUTYH-associated polyposis (MAP), which is caused due to biallelic mutations in the MUTYH gene.

Risk factors for developing colonic polyps are:

  • Older age
  • Male sex
  • Diet high in fat and low in fiber
  • Excessive alcohol consumption
  • Family history of colorectal cancer, intestinal polyposis or polyps

Polyps were found to be less common in people who had inflammatory bowel illness.

https://www.ncbi.nlm.nih.gov/books/NBK430761/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139994/