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Polyp of intestine short note

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NCI colon polyps types symptoms diagnosis treatment

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Intestinal polyp

An intestinal polyp is a localized projection of mucosa into the intestinal lumen. It may be flat, sessile (broad-based), or pedunculated (attached by a stalk). Polyps occur most often in the colon and rectum.

Types

  1. Non-neoplastic polyps
    • Hyperplastic polyps: usually small, commonly in rectosigmoid region; typically benign.
    • Inflammatory polyps (pseudopolyps): result from repeated mucosal injury and healing, such as in inflammatory bowel disease.
    • Hamartomatous polyps: disorganized overgrowth of normal tissue. Examples include juvenile polyps and Peutz-Jeghers polyps.
  2. Neoplastic polyps
    • Adenomatous polyps (adenomas): tubular, tubulovillous, or villous. They show dysplasia and are precursors of colorectal adenocarcinoma.
    • Serrated polyps: include sessile serrated lesions, which may give rise to cancer through the serrated pathway.

Clinical features

Most are asymptomatic and found during screening colonoscopy. Some may produce:
  • Rectal bleeding or occult blood loss causing iron-deficiency anemia
  • Mucus discharge
  • Altered bowel habits
  • Prolapse through anus
  • Rarely, intussusception or intestinal obstruction

Diagnosis

Colonoscopy is the investigation of choice because it permits visualization, biopsy, and removal of the polyp. Histopathology determines the type and degree of dysplasia.

Treatment

  • Endoscopic polypectomy is performed for most polyps.
  • Large, inaccessible, or malignant polyps may require surgical resection.
  • Follow-up surveillance colonoscopy depends on number, size, histology, and dysplasia of removed polyps.

Importance

Adenomatous and some serrated polyps can progress to colorectal carcinoma. The risk rises with large size, villous architecture, high-grade dysplasia, and multiple polyps. Familial syndromes such as familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis need genetic assessment and closer surveillance. The NCI colorectal genetics summary also notes that certain hamartomatous and juvenile polyps may be associated with malignant transformation.
Source: Robbins & Kumar Basic Pathology, section “Benign and Malignant Proliferative Lesions of the Colon.”
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