{"id":6662,"date":"2021-09-13T21:38:14","date_gmt":"2021-09-13T19:38:14","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/gastrointestinal-system\/polyps\/"},"modified":"2021-09-13T21:39:00","modified_gmt":"2021-09-13T19:39:00","slug":"polyps","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/gastrointestinal-system\/polyps\/","title":{"rendered":"Polyps"},"content":{"rendered":"<span class=\"block-heading\" id=\"header_1\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Definition<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">Nodular masses protruding from mucosal tissues.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Classifications<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<ul class=\"wp-block-list\"><li><strong>Non-neoplastic<\/strong><ul><li><strong>Inflammatory<\/strong><\/li><li><strong>Hamartomatous<\/strong><\/li><li><strong>Hyperplastic<\/strong><\/li><\/ul><\/li><li><strong>Neoplastic<\/strong><ul><li><strong>Adenomas<\/strong><\/li><li><strong>Familial syndromes<\/strong><\/li><li><strong>Adenocarcinomas<\/strong><\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Characteristics<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<ul class=\"wp-block-list\"><li>Polyps can be solitary or come as part of a <strong>polyposis syndrome<\/strong><ul><li>Polyposis syndromes:<ul><li><strong>Juvenile polyposis<\/strong><\/li><li><strong>Peutz-Jeghers polyposis<\/strong><\/li><li><strong>Cowden syndrome<\/strong><\/li><li><strong>Familial adenomatous polyposis<\/strong><\/li><\/ul><\/li><li>Such inherited syndromes are usually involved with the appearance of up to hundreds of polyps (hence the name&nbsp;<strong>poly<\/strong>posis), an increased risk for malignant transformation along with an extraintestinal neoplastic manifestation<\/li><\/ul><\/li><li>Polyps that have no stalk are said to be <strong>sessile<\/strong><ul><li>Seem as rounded dome-shaped outgrowths<\/li><\/ul><\/li><li>Polyps that have stalk are known said to be <strong>pedunculated<\/strong><ul><li>The stalk consists of a submucosa core<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Non-neoplastic polyps<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Inflammatory polyps<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">A polyp resulting from a recurrent insult to the mucosa, without neoplasia.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Solitary rectal ulcer syndrome<\/strong><ul><li>Impaired relaxation of the anorectal sphincter causing continuous cycles of injury and healing during stool passing<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Hamartomatous polyps<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">Disorganized mass of mature cells that are native to the site.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Juvenile Polyps<\/strong><ul><li>The most common type of hamartomatous polyp, with most tumors appearing before the age of 5 (hence, <strong>juvenile<\/strong>)<\/li><li>Can be solitary and sporadic, or part of <strong>Juvenile Polyposis syndrome<\/strong><\/li><li>Most often arises in the rectum, can protrude or ulcerate<\/li><li>Increases the risk for the development of CRC<\/li><\/ul><\/li><li><strong>Peutz-Jeghers Polyps<\/strong><ul><li>Appear as part of the <strong>Peutz-Jeghers syndrome<\/strong><\/li><li>Mucocutaneous pigmented proliferation<\/li><li>The polyps can be large<\/li><li>Increases the risk for the development of several types of cancer (breast, lung, gonadal)<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Hyperplastic Polyps<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">Epithelial proliferation, seen as &#8220;pileup&#8221; of goblet cells &#8212; hence, it is not neoplastic, but rather a decreased rate cell shedding.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Benign<\/li><li>Develop mostly in older adults<\/li><li>Can sometimes be confused with adenomas<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Neoplastic<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Adenomas<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<ul class=\"wp-block-list\"><li>Most common and clinically important neoplastic polyps<\/li><li>Benign<\/li><li>Characterized by <strong>epithelial dysplasia<\/strong><ul><li>Epithelial crowding may give a <strong>serrated<\/strong> appearance to the epithelium (like a saw-tooth)<\/li><li>In low-grade dysplasia, mucous production is diminished (compared to normal tissue)<\/li><li>In high-grade dysplasia, there is no mucus production<\/li><\/ul><\/li><li>Give rise to the majority of colorectal adenocarcinomas<ul><li>Only a small percentage of adenomatous polyps will progress to adenocarcinomas<\/li><li>Larger polyps (&gt;1.5cm) show a higher risk of progression to malignancy<\/li><\/ul><\/li><li>Morphologically, can be classified to <strong>tubular<\/strong>, <strong>villous, <\/strong>and <strong>tubulovillous<\/strong><ul><li>These classifications alone, however, have little diagnostic significance<\/li><\/ul><\/li><li>For patients over the age of 50, it is recommended to undergo colonoscopy every 2-3 years in order to remove large polyps<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Familial syndromes<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Familial adenomatous polyposis (FAP)<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<ul class=\"wp-block-list\"><li>Presents as <strong>numerous colorectal adenomatous polyps<\/strong> appearing before adulthood<ul><li>At least 100 are required (diagnostic criteria)<\/li><li>May reach up to several thousands of polyps<\/li><\/ul><\/li><li>Mutation of the&nbsp;<strong>adenomatous polyposis coli&nbsp;<\/strong>(APC) gene<ul><li>Autosomal dominant<\/li><\/ul><\/li><li>Variants of FAP<ul><li><strong>Gardner&#8217;s syndrome<\/strong><\/li><li><strong>Turcot syndrome<\/strong><\/li><li>FAP variants usually present with extraintestinal tumors as well<\/li><\/ul><\/li><li><strong>Untreated FAP will always lead to the development of colorectal adenocarcinoma<\/strong> and&nbsp;an increased risk for extraintestinal neoplasias<ul><li>Treatment includes colectomy<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_12\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Hereditary Nonpolyposis Colorectal Cancer (HNPCC)<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_12\">\n\n\n<ul class=\"wp-block-list\"><li>Also known as <strong>Lynch syndrome<\/strong><ul><li>Originally described as familial clustering of cancer at different sites such as CRC, female genital tract, brain and skin<\/li><\/ul><\/li><li>Adenomatous polyps are present but not in excessive numbers (hence, it is <strong>not<\/strong> a polyposis syndrome)<\/li><li>HNPCC is characterized by mutation of <strong>MSH2 or MLH1 DNA mismatch repair <\/strong>(MMR)&nbsp;genes<ul><li>Genes coding proteins responsible for DNA replication error detection and repair<\/li><li>Individuals with HNPCC inherit a mutated allele; with time, the second allele will be lost (or silenced due to epigenetic modifications) &#8212; two-hit hypothesis<ul><li>MMR defects lead to <strong>microsatellite instability <\/strong>&#8212; the accumulation of mutations in short repeating DNA sequences known as microsatellite DNA<\/li><\/ul><\/li><\/ul><\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Definition<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Classifications<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Characteristics<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Non-neoplastic polyps<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Inflammatory polyps<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Hamartomatous polyps<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Hyperplastic Polyps<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Neoplastic<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Adenomas<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Familial syndromes<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Familial adenomatous polyposis (FAP)<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Hereditary Nonpolyposis Colorectal Cancer (HNPCC)<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Definition Nodular masses protruding from mucosal tissues. Classifications Non-neoplastic Inflammatory Hamartomatous Hyperplastic Neoplastic Adenomas Familial syndromes Adenocarcinomas Characteristics Polyps can be solitary or come as part of a polyposis syndrome Polyposis syndromes: Juvenile polyposis Peutz-Jeghers polyposis Cowden syndrome Familial adenomatous polyposis Such inherited syndromes are usually involved with the appearance of up to hundreds of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":404,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6662","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Polyps &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/gastrointestinal-system\/polyps\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/gastrointestinal-system\\\/polyps\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/gastrointestinal-system\\\/polyps\\\/\",\"name\":\"Polyps &#8211; 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