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Acta Gastro-enterologica Belgica 2021
Topics: Anal Canal; Colonoscopy; Humans; Intestinal Polyps; Rectum
PubMed: 34217197
DOI: 10.51821/84.2.387 -
Current Opinion in Gastroenterology Jan 2022The goal of this review is to help providers recognize, diagnose and manage gastrointestinal (GI) polyposis syndromes. (Review)
Review
PURPOSE OF REVIEW
The goal of this review is to help providers recognize, diagnose and manage gastrointestinal (GI) polyposis syndromes.
RECENT FINDINGS
Intestinal polyps include a number of histological sub-types such as adenomas, serrated, hamartomas among others. Over a quarter of individuals undergoing screening colonoscopy are expected to have colonic adenomas. Although it is not uncommon for adults to have a few GI polyps in their lifetime, some individuals are found to have multiple polyps of varying histology throughout the GI tract. In these individuals, depending on polyp histology, number, location and size as well as extra-intestinal features and/or family history, a polyposis syndrome should be considered with appropriate testing and management.
SUMMARY
Diagnosis and management of polyposis syndromes has evolved with advent of multigene panel testing and new data on optimal surveillance strategies. Evidence-based recommendations and current practice guidelines for polyposis syndromes are reviewed here. Areas of uncertainty and future research are also highlighted.
Topics: Adenoma; Adult; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Humans; Intestinal Polyps; Peutz-Jeghers Syndrome
PubMed: 34839308
DOI: 10.1097/MOG.0000000000000796 -
Acta Clinica Croatica Aug 2022Colorectal juvenile polyp as a pathologic entity was first described by Verse. These non-neoplastic lesions are most commonly found in children and infants, while in...
Colorectal juvenile polyp as a pathologic entity was first described by Verse. These non-neoplastic lesions are most commonly found in children and infants, while in older children after the age of 14 and adults are a rare phenomenon. A 75-year-old female underwent colonoscopy. There was a pedunculated polyp in the transverse colon. Complete endoscopic electroresection of this polyp was performed and the polyp was sent for histopathologic analysis. Macroscopically, the polyp was described as a fragment of irregular round shape, size of about 2.5x2x1 cm, with fine-grained, reddish surface, showing dark red color on serial sections. Histologic examination of the polyp showed some irregularly distributed glands, some of which were cystically dilated. All glandular formations were coated with normal intestinal epithelium. The surface of the polyp was partially eroded and replaced by non-specific cellular granulation tissue. There were some signs of hemorrhagic infarction in the stroma of the polyp. Histopathologic examination indicated that histopathologic characteristics of this polyp corresponded to juvenile polyp. Juvenile polyps are very rarely found in adults. Therefore, we describe a case of this patient in her eighties with juvenile polyp localized in the transverse colon.
Topics: Child; Infant; Female; Humans; Adult; Aged; Colonic Polyps; Colonoscopy; Hamartoma
PubMed: 36818922
DOI: 10.20471/acc.2022.61.02.23 -
Archives of Pathology & Laboratory... Mar 2019Duodenal epithelial polyps are reported in 1.5% to 3% of individuals referred for upper endoscopy. Most duodenal epithelial polyps are asymptomatic and nonneoplastic;... (Review)
Review
CONTEXT.—
Duodenal epithelial polyps are reported in 1.5% to 3% of individuals referred for upper endoscopy. Most duodenal epithelial polyps are asymptomatic and nonneoplastic; however, a small subset is neoplastic and may progress to adenocarcinoma. Recent advances in immunohistochemical and molecular techniques have helped further characterize these polyps, shedding light on their origin, classification, and risk of progression to adenocarcinoma.
OBJECTIVE.—
To provide a comprehensive clinicopathologic review of nonneoplastic and neoplastic duodenal epithelial polyps, with particular emphasis on recent developments in classification schemes and risk stratification based upon immunohistochemical and molecular profiles.
DATA SOURCES.—
This review is based on peer-reviewed literature and the authors' experiences.
CONCLUSIONS.—
In this review we provide an update on the clinicopathologic, immunohistochemical, and molecular features of duodenal epithelial polyps and discuss the surveillance recommendations and treatment options available. Particular attention should be placed on recognizing duodenal adenomas with intestinal, gastric, and serrated phenotype, as they have an increased risk of malignant transformation if not completely excised.
Topics: Duodenum; Humans; Intestinal Mucosa; Intestinal Polyps
PubMed: 30354274
DOI: 10.5858/arpa.2018-0034-RA -
World Journal of Gastroenterology Jul 2010Nowadays, the number of cases in which malignant colorectal polyps are removed is increasing due to colorectal cancer screening programmes. Cancerous polyps are...
Nowadays, the number of cases in which malignant colorectal polyps are removed is increasing due to colorectal cancer screening programmes. Cancerous polyps are classified into non-invasive high grade neoplasia (NHGN), when the cancer has not reached the muscularis mucosa, and malignant polyps, classed as T1, when they have invaded the submucosa. NHGN is considered cured with polypectomy, while the prognosis for malignant polyps depends on various morphological and histological factors. The prognostic factors include, sessile or pedunculated morphology of the polyp, whether partial or en bloc resection is carried out, the degree of differentiation of the carcinoma, vascular or lymphatic involvement, and whether the polypectomy resection margin is tumor free. A malignant polyp at T1 is considered cured with polypectomy if it is a pedunculated polyp (Ip of the Paris classification), it has been completely resected, it is not poorly differentiated, the resection edge is not affected by the tumor and there is no vascular or lymphatic involvement. The sessile malignant polyp (Is of the Paris classification) at T1 is considered not cured with polypectomy. Only in some cases (e.g. older people with high surgical risk) local excision (polypectomy or endoscopic submucosal dissection or conventional endoscopic mucosal resection) is considered the definitive treatment.
Topics: Colonic Neoplasms; Diagnosis, Differential; Humans; Intestinal Polyps; Lymphatic Metastasis; Neoplasm Staging; Prognosis; Rectal Neoplasms; Treatment Outcome
PubMed: 20593495
DOI: 10.3748/wjg.v16.i25.3103 -
Acta Gastro-enterologica Belgica 2021
Topics: Duodenal Diseases; Humans; Intestinal Polyps; Polyps
PubMed: 34599583
DOI: 10.51821/84.2.021 -
Zeitschrift Fur Gastroenterologie Dec 1972
Topics: Colonic Diseases; Endoscopy; Humans; Intestinal Polyps; Proctoscopy; Sigmoidoscopy
PubMed: 4657271
DOI: No ID Found -
Acta Gastro-enterologica Belgica 2020In childhood, clinical presentation of intes- tinal polyps is variable. Painless rectal red blood loss is the most common presenting sign. Most polyps are sporadic,...
BACKGROUND/AIMS
In childhood, clinical presentation of intes- tinal polyps is variable. Painless rectal red blood loss is the most common presenting sign. Most polyps are sporadic, isolated and benign. However, it is important to correctly identify exceptions. Rare inherited polyposis syndromes need to be recognized because of their increased risk of intestinal and extra-intestinal malignancies. Furthermore, a correct diagnosis and treatment of rare gastro-intestinal malignancies is crucial.
METHODS
Between 2016 and 2018 we encountered 4 different types of intestinal polyps. A database search was performed and patient files were checked for clinical manifestations and histo- pathology. Literature was searched to recapitulate red flags for these syndromes, probability of underlying genetic disorders and diagnostic criteria.
RESULTS
Between 2016 and 2018, 28 patients presented at the Ghent University Hospital with 30 juvenile polyps. Furthermore, we diagnosed juvenile polyposis syndrome, Li Fraumeni syndrome and familial adenomatous polyposis (FAP) in 1 patient each, whilst 2 FAP patients were in follow-up. Each of these diagnoses has a different lifetime risk of (extra)-intestinal malignancy and requires a different approach and follow-up. Histopathology and genetic testing play an important role in identifying these syndromes in pediatric patients.
CONCLUSION
Although most intestinal polyps in childhood are benign juvenile polyps that require no follow-up, rare inherited syndromes should be considered and correctly diagnosed since adequate follow-up is necessary to reduce morbidity and mortality from both gastrointestinal and extraintestinal complications and malignancies.
Topics: Adenomatous Polyposis Coli; Adolescent; Child; Genetic Testing; Humans; Intestinal Polyposis; Intestinal Polyps
PubMed: 33094585
DOI: No ID Found -
Journal of Healthcare Engineering 2022To explore the factors affecting the adenoma risk level in patients with intestinal polyp and association.
OBJECTIVE
To explore the factors affecting the adenoma risk level in patients with intestinal polyp and association.
METHODS
The clinical data of 3,911 patients with intestinal polyp treated in our hospital from January 2018 to January 2021 were retrospectively analyzed, all patients accepted the histopathological examination, their risk of suffering from adenoma was evaluated according to the results of pathological diagnosis, and relevant hazard factors affecting adenoma risk level in them were analyzed by multifactor logistic regression analysis.
RESULTS
The results of multifactor logistic analysis showed that male gender, age ≥60 years, number of polyps >3, diameter ≥2 cm, onset at colon, and physiologically tubulovillous adenoma were the hazard factors causing high-grade adenoma risk in patients with intestinal polyp.
CONCLUSION
There are many risk factors causing high-grade adenoma in patients with intestinal polyp, and therefore, the screening for high-risk population shall be enhanced to reduce the potential of carcinomatous change in such patients.
Topics: Adenoma; Colon; Colonic Polyps; Humans; Intestinal Polyps; Male; Middle Aged; Retrospective Studies
PubMed: 35075394
DOI: 10.1155/2022/9479563 -
Annals of Surgery Aug 1984During a 6-year period from 1976 to 1982, 7346 gastrointestinal endoscopy procedures were performed in the Surgical Endoscopy Unit of Beth Israel Medical Center. This...
During a 6-year period from 1976 to 1982, 7346 gastrointestinal endoscopy procedures were performed in the Surgical Endoscopy Unit of Beth Israel Medical Center. This report summarizes our experience with 443 gastroduodenal polyps excised in 257 patients. Of these, 123 were male and 134 female, ranging in age from 19 to 92. The vast majority were between the ages of 60 and 80. With one exception, polyps varied from 0.3 cm to 6 cm in diameter (one patient had a 12-cm hyperplastic polyp). There were 399 gastric polyps in 238 patients and 44 duodenal polyps in 19 patients. Of the polyps excised, 282 (63.1%) were sessile and 161 (36.9%) were pedunculated. The majority of the patients (185) had a single polyp and 72 patients had two or more polyps. Seven patients with multiple polyps had Peutz-Jeghers Syndrome and two patients had Gardner's Syndrome. Hyperplastic polyps constituted the majority (62%) of the polyps. These polyps have minimal, if any, tendency to degenerate into carcinoma. In contrast, adenomatous gastroduodenal polyps (21%) have a definite propensity to degenerate into carcinoma. This occurred in 9.6% of the patients in this series. There were no deaths and only two complications (bleeding) in this series.
Topics: Adenoma; Adult; Aged; Duodenal Neoplasms; Duodenoscopy; Female; Follow-Up Studies; Gardner Syndrome; Gastroscopy; Humans; Intestinal Polyps; Male; Middle Aged; Peutz-Jeghers Syndrome; Polyps; Postoperative Complications; Stomach Neoplasms
PubMed: 6465972
DOI: 10.1097/00000658-198408000-00010