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Gastrointestinal tract polyps (view source)
Revision as of 01:36, 18 March 2011
, 01:36, 18 March 2011→Tabular comparison of colonic polyps
m (→Adenomatous polys: +FAP) |
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=Tabular comparison of colonic polyps= | =Tabular comparison of colonic polyps= | ||
==Overview== | |||
{| class="wikitable" | |||
| '''Type''' | |||
| '''Key feature(s)''' | |||
| '''Details''' | |||
| '''Prevalence / prognosis''' | |||
| '''Other''' | |||
| '''DDx''' | |||
| '''Image''' | |||
|- | |||
| Normal | |||
| test tube-like morphology | |||
| small nuclei, abundant goblet cells | |||
| common / benign | |||
| - | |||
| microscopic colitis, colonic spirochetes, microsporidiosis | |||
| Image? | |||
|- | |||
| Hyperplastic polyp | |||
| serrated at the surface | |||
| abundant goblet cells, usu. left colon | |||
| common / benign | |||
| may be syndromic | |||
| sessile serrated adenoma | |||
| [http://commons.wikimedia.org/wiki/File:Hyperplastic_polyp2.jpg HP (WC)] | |||
|- | |||
| Traditional adenomas | |||
| nuclear hyperchromasia & pseudostratification/crowding at the surface, usu. polypoid - on a stalk, usu. left colon | |||
| decreased goblet cells | |||
| common / premalignant | |||
| tubular adenoma, tubulovillous adenoma, villous adenoma | |||
| traditional serrated adenoma, reactive changes (inflammation) | |||
| [http://commons.wikimedia.org/wiki/File:Tubular_adenoma_2_high_mag.jpg TA - high mag. (WC)], [http://commons.wikimedia.org/wiki/File:Tubular_adenoma_4_low_mag.jpg TA - low mag. (WC)] | |||
|- | |||
| Sessile serrated adenoma | |||
| basal crypt dilation & serration | |||
| boot-shaped crypts, horizontal crypts, branching crypts | |||
| uncommon / premalignant | |||
| AKA sessile serrated polyp | |||
| hyperplastic polyp | |||
| [http://commons.wikimedia.org/wiki/File:Sessile_serrated_adenoma_2_low_mag.jpg SSA - low mag. (WC)] | |||
|- | |||
| Traditional serrated adenoma | |||
| nuclear hyperchromasia & pseudostratification/crowding at the surface, serrated, villous-like architecture | |||
| decreased goblet cells | |||
| very rare / premalignant | |||
| | |||
| traditional serrated adenoma (esp. villous adenoma) | |||
| [http://commons.wikimedia.org/wiki/File:Traditional_serrated_adenoma_low_mag.jpg TSA - low mag. (WC)], [http://commons.wikimedia.org/wiki/File:Traditional_serrated_adenoma_very_high_mag.jpg TSA - high mag. (WC)] | |||
|- | |||
| Juvenile polyp (retension polyp) | |||
| dilated glands, increased lamina propria | |||
| eroded surface (due to trauma), stalk (polypoid) | |||
| uncommon / benign if in isolation | |||
| may be part of a syndrome | |||
| inflammatory pseudopolyp | |||
| [http://commons.wikimedia.org/wiki/File:Gastric_juvenile_polyp_-_very_low_mag.jpg Gastric JP - low mag. (WC)] | |||
|- | |||
| Inflammatory pseudopolyp | |||
| inflammation, erosion/ulceration adjacent to polyp | |||
| loss of mucosa adjacent to pseudopolyp | |||
| uncommon / seen in IBD, increased risk of malignancy | |||
| only seen in IBD; Dx implies IBD | |||
| juvenile polyp | |||
| Image | |||
|- | |||
| Peutz-Jeghers polyp (PJP) | |||
| branching smooth muscle | |||
| tree-like growth pattern | |||
| very rare / syndromic; assoc. with cancer | |||
| PJP not premalignant lesion in itself | |||
| normal | |||
| [http://commons.wikimedia.org/wiki/File:Peutz-Jeghers_syndrome_polyp.jpg PJP - low mag. (WC)] | |||
|} | |||
==Common problems== | |||
Adenomatous polyps & hyperplastic polyps - a comparison (adapted from Li and Burgart<ref>{{cite journal |author=Li SC, Burgart L |title=Histopathology of serrated adenoma, its variants, and differentiation from conventional adenomatous and hyperplastic polyps |journal=Arch. Pathol. Lab. Med. |volume=131 |issue=3 |pages=440-5 |year=2007 |month=March |pmid=17516746 |doi= |url=http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=0003-9985&volume=131&page=440}}</ref>): | Adenomatous polyps & hyperplastic polyps - a comparison (adapted from Li and Burgart<ref>{{cite journal |author=Li SC, Burgart L |title=Histopathology of serrated adenoma, its variants, and differentiation from conventional adenomatous and hyperplastic polyps |journal=Arch. Pathol. Lab. Med. |volume=131 |issue=3 |pages=440-5 |year=2007 |month=March |pmid=17516746 |doi= |url=http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=0003-9985&volume=131&page=440}}</ref>): | ||
{| class="wikitable" | {| class="wikitable" | ||