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Fukuoka Igaku Zasshi = Hukuoka Acta... Apr 2015We experienced an extremely rare case of gastric hyperplastic polyp with xanthoma. A 73-year-old Japanese man was transferred to our hospital from a referral hospital... (Review)
Review
We experienced an extremely rare case of gastric hyperplastic polyp with xanthoma. A 73-year-old Japanese man was transferred to our hospital from a referral hospital for further evaluation of a pedunculated gastric polyp and early gastric cancer. Esophagogastroduodenoscopy (EGD) revealed a yellow-whitish pedunculated polyp arising from the anterior wall of the fornix. Magnification narrow-band imaging (NBI) endoscopy revealed extended and tortuous microcapillaries and a swollen interfoveolar pattern on the polyp's surface, but there was no sign of malignancy. Endoscopic ultrasonography (EUS) revealed an irregularity of the first layer and a thickened second layer. The third layer was intact. A hyperechoic area was seen in the thickened second layer. Endoscopic submucosal dissection (ESD) for early carcinoma of the antrum and endoscopic mucosal resection (EMR) for a polyp in the fornix were performed in one session. Histological examination of the specimen of the fornix polyp revealed lengthened, branched and dilatated gastric foveolae and a tight sheet of foamy histiocytes in the stroma. The background mucosa of the polyp was atrophic. The pathologic evidence was gastric hyperplastic polyp with proliferation of xanthoma. The early cancer of the antrum was intramucosal tubular adenocarcinoma and was resected curatively.
Topics: Adenomatous Polyps; Aged; Endosonography; Gastroscopes; Humans; Male; Stomach Diseases; Stomach Neoplasms; Xanthomatosis
PubMed: 26117951
DOI: No ID Found -
TheScientificWorldJournal Jun 2004
Topics: Adenomatous Polyps; Adult; Hematuria; Humans; Male; Treatment Outcome; Urethral Neoplasms; Urinary Bladder Neck Obstruction
PubMed: 15349532
DOI: 10.1100/tsw.2004.51 -
AJR. American Journal of Roentgenology Nov 2009Hyperplastic polyps are more difficult to detect than adenomatous polyps at CT colonography (CTC), and it has been theorized that this difference in detectability is...
OBJECTIVE
Hyperplastic polyps are more difficult to detect than adenomatous polyps at CT colonography (CTC), and it has been theorized that this difference in detectability is because hyperplastic polyps are flatter. Using automated software that computes polyp height, we determined whether hyperplastic colonic polyps on CTC are indeed flatter than adenomatous polyps of comparable width.
MATERIALS AND METHODS
At three medical centers, 1,186 patients underwent oral contrast-enhanced CTC and same-day optical colonoscopy (OC) with segment unblinding for colorectal cancer screening. One hundred eighty-five of the patients had at least one hyperplastic or adenomatous polyp 6-10 mm visible at both OC and CTC, where size was determined by a calibrated guidewire at OC. To assess flatness, the heights of the polyps at CTC were measured using a validated automated software program. The heights and height-to-width ratios of the hyperplastic polyps were compared with those of the adenomatous polyps using a Student's t test (two-tailed, unpaired, unequal variance).
RESULTS
There were 176 adenomatous and 83 hyperplastic polyps visible at segment-unblinded OC. The fraction of these polyps that were measurable at CTC using the automated software was not significantly different for adenomatous versus hyperplastic polyps (158/176 [89.8%] vs 73/87 [83.9%], respectively; p = 0.2). The average height-to-width ratios using automated width measurements were 15% less for hyperplastic polyps: 0.39 +/- 0.20 (n = 158) and 0.33 +/- 0.19 (n = 73) for adenomatous and hyperplastic polyps, respectively (p = 0.03). When polyps of comparable OC size or CTC width were considered, the heights of hyperplastic polyps were up to 27% less than those of adenomatous polyps.
CONCLUSION
For 6-10 mm polyps of a given size as determined by OC or a given width at CTC, hyperplastic polyps tend to be flatter (i.e., have lower height) compared with adenomatous polyps.
Topics: Adenomatous Polyps; Aged; Analysis of Variance; Automation; Colonic Polyps; Colonography, Computed Tomographic; Colonoscopy; Contrast Media; Female; Humans; Hyperplasia; Male; Middle Aged; Radiographic Image Interpretation, Computer-Assisted; Retrospective Studies; Software
PubMed: 19843746
DOI: 10.2214/AJR.09.2442 -
World Journal of Gastroenterology Sep 2017To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers.
AIM
To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers.
METHODS
For purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test). To determine if the effectiveness of education was sustained, four months later, a third, follow-up test was performed with the same participants.
RESULTS
The overall Fleiss' kappa value of the inter-observer agreement was 0.510 in the pre-test, 0.618 in the post-test, and 0.580 in the follow-up test. The overall diagnostic accuracy of the estimation for polyp morphology in the pre-, post-, and follow-up tests was 0.662, 0.797, and 0.761, respectively. After education, the inter-observer agreement and diagnostic accuracy of all participants improved. However, after four months, the inter-observer agreement and diagnostic accuracy of expert groups were markedly decreased, and those of beginner and nurse groups remained similar to pre-test levels.
CONCLUSION
The education program used in this study can improve inter-observer agreement and diagnostic accuracy in assessing the morphology of colon polyps; it is especially effective when first learning endoscopy.
Topics: Adenomatous Polyps; Clinical Competence; Colon; Colonic Neoplasms; Colonic Polyps; Colonoscopy; Education, Medical, Continuing; Humans; Observer Variation; Quality Improvement; Republic of Korea; Time Factors; Video Recording
PubMed: 28974894
DOI: 10.3748/wjg.v23.i34.6281 -
Journal of Ultrasound in Medicine :... Mar 2022This study aimed to determine ultrasonic image characteristics that enable differentiation between cholesterol and adenomatous polyps and to assess the diagnostic...
OBJECTIVES
This study aimed to determine ultrasonic image characteristics that enable differentiation between cholesterol and adenomatous polyps and to assess the diagnostic efficacy of combining conventional ultrasound (CUS) with contrast-enhanced ultrasound (CEUS).
METHODS
Eighty-nine patients with gallbladder polyps of 1-2 cm in diameter were enrolled and examined by CUS and CEUS before cholecystectomy. The appearances on CUS and CEUS were recorded and analyzed. The receiver operating characteristic (ROC) curve was used to calculate the optimal size threshold for distinguishing cholesterol from adenomatous polyps. A logistic regression analysis was performed to identify diagnostic variables. ROC analysis was performed to evaluate the diagnostic efficacy of the size, the independent variables, and the combined factors.
RESULTS
There were differences in size, number, vascularity on CUS and intralesional vascular shape, wash-out, and area under the curve on CEUS between the two groups (P < .05). ROC analysis indicated that a maximum diameter of 1.45 cm was the optimal threshold for the prediction of adenomatous polyps. The logistic regression analysis proved that the single polyp, presence of vascularity, and intralesional linear vessels were associated with adenomatous polyps (P < .05). ROC analysis showed that the area under the ROC curve, sensitivity, and specificity for the combination of the three independent variables were 0.858, 87.3%, and 67.6%. The number combined with intralesional vascular shape had the highest diagnostic sensitivity of 91.2%.
CONCLUSIONS
The combination of CUS and CEUS demonstrated great significance in the differential diagnosis of cholesterol and adenomatous polyps.
Topics: Adenomatous Polyps; Cholesterol; Contrast Media; Diagnosis, Differential; Gallbladder Neoplasms; Humans; Polyps; Ultrasonography
PubMed: 33938029
DOI: 10.1002/jum.15740 -
Gastrointestinal Endoscopy Mar 2019Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma... (Observational Study)
Observational Study
BACKGROUND AND AIMS
Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer-driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automated polyp detection software (APDS) under routine colonoscopy conditions.
METHODS
This was a prospective study at a university hospital in Germany. A prototype of a novel APDS ("KoloPol," Fraunhofer IIS, Erlangen, Germany) was used for automated image-based polyp detection. The software functions by highlighting structures of possible polyp lesions in a color-coded manner during real-time colonoscopy procedures. Testing the feasibility of APDS deployment under real-time conditions was the primary goal of the study. APDS polyp detection rates (PDRs) were defined as secondary endpoints provided that endoscopists' detection served as criterion standard.
RESULTS
The APDS was applied in 55 routine colonoscopies without the occurrence of any clinically relevant adverse events. Endoscopists' PDRs and ADRs were 56.4% and 30.9%, respectively. The PDRs and ADRs of the APDS were 50.9% and 29.1%, respectively. The APDS detected 55 of 73 polyps (75.3%). Smaller polyp size and flat polyp morphology were correlated with insufficient polyp detection by the APDS.
CONCLUSION
Computer-assisted automated low-delay polyp detection is feasible during real-time colonoscopy. Efforts should be undertaken to improve the APDS with respect to smaller and flat shaped polyps. (Clinical trial registration number: NCT02838888.).
Topics: Adenoma; Adenomatous Polyps; Aged; Automation; Carcinoma; Cohort Studies; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Female; Humans; Image Processing, Computer-Assisted; Logistic Models; Male; Middle Aged; Odds Ratio; Prospective Studies; Software; Tumor Burden
PubMed: 30342029
DOI: 10.1016/j.gie.2018.09.042 -
Indian Journal of Gastroenterology :... Jun 2010To evaluate whether statin use was associated with recurrent adenomatous polyps.
PURPOSE
To evaluate whether statin use was associated with recurrent adenomatous polyps.
METHODS
We conducted a retrospective cohort study. We used electronic health records to evaluate veterans who underwent polypectomy between January 1, 1999 and December 31, 2001 and surveillance colonoscopy by December 2006. We obtained data on pathology, demographics, body mass index, comorbidity, habits, family history, and medications. We used multivariate proportional hazards regression models to analyze data.
RESULTS
We evaluated 197 eligible patients from among 821 who underwent colonoscopy during this period; their mean (SD) age was 63.1 (8.8) years, 192 (98%) were men, and 80 (41%) non-Hispanic white. Surveillance colonoscopy was performed after a mean (SD) 1207 (452) days and 108 (55%) patients had recurrent adenomas. During follow-up, 88 (47%) of patients received statins, but use was not protective against recurrent adenomas (hazard ratio = 1.36, 95% CI 0.35-8.27). Only number of polyps at initial colonoscopy predicted recurrent adenomas (1.98, 95% CI 1.27-3.08).
CONCLUSIONS
The use of statins was not protective against the recurrence of adenomatous polyps.
Topics: Adenomatous Polyposis Coli; Colonoscopy; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Middle Aged; Neoplasm Recurrence, Local; Poisson Distribution; Proportional Hazards Models; Retrospective Studies; Statistics, Nonparametric; Treatment Outcome; Veterans
PubMed: 20658327
DOI: 10.1007/s12664-010-0032-1 -
Helicobacter pylori Eradication Regressed Gastric Hyperplastic Polyp: A Randomized Controlled Trial.Digestive Diseases and Sciences Dec 2020Helicobacter pylori infection and hyperplastic polyp are known to have strong connections, but there are not enough randomized controlled trial data. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Helicobacter pylori infection and hyperplastic polyp are known to have strong connections, but there are not enough randomized controlled trial data.
AIMS
To evaluate the effect of H. pylori eradication on gastric hyperplastic polyp.
METHOD
This is an open-labeled, single-center, randomized controlled trial. Patients with hyperplastic polyp and current infection of H. pylori were randomly assigned to eradication or non-eradication groups. All participants underwent follow-up endoscopy to investigate the regression of gastric polyps. Gastric polyp regression was defined as the disappearance of polyps or a reduction of more than 50% in size.
RESULTS
Thirty-two patients were randomized to eradication (n = 17) and non-eradication groups (n = 15). Final included patients were 14 in eradication group and 13 in non-eradication group. All patients showed polyp regression in eradication group, whereas no regression was observed in non-eradication group (P < 0.001). Disappearance of polyp (n = 7) and decrease in size (n = 7) were observed in eradication group. In non-eradication group, no change (n = 5), increase of size (n = 5), and increase of number (n = 3) were observed. Mean regression time was 6.8 months, and disappearance time was 9.8 months. In non-eradication group, hyperglycemia was noted in 50% of progression group but not noted in no change group (P = 0.057).
CONCLUSIONS
H. pylori eradication induced regression of hyperplastic polyp, and persistent H. pylori infection was related to progression of gastric polyp.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov ID: NCT03065868.
Topics: Adenomatous Polyps; Amoxicillin; Anti-Bacterial Agents; Breath Tests; Clarithromycin; Drug Monitoring; Endoscopy, Digestive System; Female; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Male; Middle Aged; Outcome Assessment, Health Care; Proton Pump Inhibitors; Stomach Neoplasms
PubMed: 31974914
DOI: 10.1007/s10620-020-06065-0 -
Klinicka Onkologie : Casopis Ceske a... 2013The most common premalignant lesions of colorectal carcinoma include sporadic adenomas. Tubular and tubulovillous adenomas with mild dysplasia are considered benign... (Review)
Review
The most common premalignant lesions of colorectal carcinoma include sporadic adenomas. Tubular and tubulovillous adenomas with mild dysplasia are considered benign lesions, while villous adenomas represent tumors with uncertain bio-logical behavior. In recent years, demonstrable growth of flat lesions in the proximal intestine has been seen. Precision and yield of colonoscopy depends to some extent on good preparation, careful screening of intestine and use of new instruments of better quality. As an indicator of screening colonoscopy quality, the so -called adenoma detection rate is used. The text briefly describes options of endoscopic and surgical resolving of premalignancies. In the Czech Republic, attendance in the screening program is low, which could be changed by prepared addressed invitations of clients. The population with a genetic or familiar risk is examined according to recommended procedures intended for increased- risk persons.
Topics: Adenomatous Polyps; Colonoscopy; Colorectal Neoplasms; Humans; Hyperplasia; Mass Screening; Precancerous Conditions
PubMed: 24325162
DOI: 10.14735/amko2013s38 -
Gut Sep 2010Gastric polyps are important as some have malignant potential. If such polyps are left untreated, gastric cancer may result. The malignant potential depends on the... (Review)
Review
BACKGROUND
Gastric polyps are important as some have malignant potential. If such polyps are left untreated, gastric cancer may result. The malignant potential depends on the histological type of the polyp. The literature base is relatively weak and any recommendations made must be viewed in light of this.
DEFINITION
Gastric polyps are sessile or pedunculated lesions that originate in the gastric epithelium or submucosa and protrude into the stomach lumen.
MALIGNANT POTENTIAL
Depending on histological type, some gastric polyps (adenomas and hyperplastic polyps) have malignant potential and are precursors of early gastric cancer. They may also indicate an increased risk of intestinal or extra-intestinal malignancy.
Topics: Adenomatous Polyps; Carcinoid Tumor; Evidence-Based Medicine; Gastroscopy; Humans; Polyps; Precancerous Conditions; Stomach Diseases; Stomach Neoplasms
PubMed: 20675692
DOI: 10.1136/gut.2009.182089