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Difference between revisions of "Gastrointestinal tract polyps"
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Gastrointestinal tract polyps (view source)
Revision as of 02:38, 20 June 2010
, 02:38, 20 June 2010redo PBoD
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'''Intestinal polyps''' are often the bread & butter of a GI pathologists workload. Some of 'em are benign... some pre-malignant... some malignant... some weird. | '''Intestinal polyps''' are often the bread & butter of a GI pathologists workload. Some of 'em are benign... some pre-malignant... some malignant... some weird. | ||
Overview - there are four basic types:<ref>PBoD | Overview - there are four basic types:<ref>{{Ref PBoD|856}}</ref> | ||
*Hyperplastic - harmless, most common - 90% of all colonic polyps.<ref>PBoD | *Hyperplastic - harmless, most common - 90% of all colonic polyps.<ref>{{Ref PBoD|858}}</ref> | ||
*Hamartomatous - weriod stuff, syndromic things. | *Hamartomatous - weriod stuff, syndromic things. | ||
*Inflammatory - think [[inflammatory bowel disease]], aka ''pseudopolyps''. | *Inflammatory - think [[inflammatory bowel disease]], aka ''pseudopolyps''. | ||
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{{familytree | | | | | H | | I | | J |H=TA|I=TVA|J=VA}} | {{familytree | | | | | H | | I | | J |H=TA|I=TVA|J=VA}} | ||
{{familytree/end}} | {{familytree/end}} | ||
Notes:<ref>PBoD | Notes:<ref>{{Ref PBoD|860}}</ref> | ||
*TA, tubular component >75%. | *TA, tubular component >75%. | ||
*VA, villous component >50%. | *VA, villous component >50%. | ||
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==Hyperplastic polyp== | ==Hyperplastic polyp== | ||
*Most common colonic polyp (90% of all colonic polyps<ref>PBoD | *Most common colonic polyp (90% of all colonic polyps<ref>{{Ref PBoD|858}}</ref>). | ||
===Microscopy=== | ===Microscopy=== | ||
Features:<ref>PBoD | Features:<ref>{{Ref PBoD|858}}</ref> | ||
*Irregular crypt architecture - tortuosity. | *Irregular crypt architecture - tortuosity. | ||
*Serrated epithelial cells (at the surface of the gland). | *Serrated epithelial cells (at the surface of the gland). | ||
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====Typing==== | ====Typing==== | ||
Subclassified as:<ref name=pbod860>PBoD | Subclassified as:<ref name=pbod860>{{Ref PBoD|860}}</ref> | ||
*Tubular (most common), tubular component >75%. | *Tubular (most common), tubular component >75%. | ||
*Villous (least common ~= 1% of (traditional) adenomas), villous component >50%. | *Villous (least common ~= 1% of (traditional) adenomas), villous component >50%. | ||
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====Microscopic==== | ====Microscopic==== | ||
Features:<ref>PBoD | Features:<ref>{{Ref PBoD|859}}</ref><ref>[http://www.nature.com/modpathol/journal/v16/n4/fig_tab/3880773f4.html http://www.nature.com/modpathol/journal/v16/n4/fig_tab/3880773f4.html]</ref> | ||
*Eroded, smooth or lobulated surface. | *Eroded, smooth or lobulated surface. | ||
*Pedunculated. | *Pedunculated. | ||
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===Peutz-Jeghers polyp=== | ===Peutz-Jeghers polyp=== | ||
====Clinical/Epidemiology==== | ====Clinical/Epidemiology==== | ||
Features:<ref>PBoD | Features:<ref>{{Ref PBoD|859}}</ref><ref>[http://www.nature.com/modpathol/journal/v16/n4/fig_tab/3880773f4.html http://www.nature.com/modpathol/journal/v16/n4/fig_tab/3880773f4.html]</ref> | ||
*Peutz-Jeghers syndrome is autosomal dominant. | *Peutz-Jeghers syndrome is autosomal dominant. | ||
*Altered gene: STK11. | *Altered gene: STK11. | ||
====Microscopy==== | ====Microscopy==== | ||
Features:<ref>PBoD | Features:<ref>{{Ref PBoD|859}}</ref><ref>[http://www.nature.com/modpathol/journal/v16/n4/fig_tab/3880773f4.html]</ref> | ||
*Frond-like polyp with all three components of mucosa: | *Frond-like polyp with all three components of mucosa: | ||
*# Muscosal epithelium (melanotic mucosa, goblet cells). | *# Muscosal epithelium (melanotic mucosa, goblet cells). | ||
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===Cowden disease=== | ===Cowden disease=== | ||
Features:<ref>PBoD | Features:<ref>{{Ref PBoD|858-9}}</ref> | ||
*Hamartomatous polyps | *Hamartomatous polyps | ||
*Facial trichilemmomas (hair follicle root sheath epithelium tumour), | *Facial trichilemmomas (hair follicle root sheath epithelium tumour), | ||
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===Cronkhite-Canada syndrome=== | ===Cronkhite-Canada syndrome=== | ||
Features:<ref>PBoD | Features:<ref>{{Ref PBoD|858-9}}</ref> | ||
*Hamartomatous polyps, | *Hamartomatous polyps, | ||
*Ectodermal abnormalities (nail atrophy, skin pigment, alopecia). | *Ectodermal abnormalities (nail atrophy, skin pigment, alopecia). | ||