Gastroenterology Book

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Colonic PolypAka: Adenomatous Colonic Polyp, Hyperplastic Colonic Polyp, Sessile Serrated Adenomatous Colonic Polyp

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  1. Types
    1. Benign
      1. Hyperplastic Colonic Polyp (except the higher risk, hyperplastic polyposis syndrome)
      2. Inflammatory Colonic Polyp
    2. Malignant Potential (require complete excision and close interval follow-up)
      1. Adenomatous Colonic Polyp
      2. Sessile Serrated Adenomatous Colonic Polyp
  2. Interpretation
    1. Factors suggesting higher risk of future adenomatous polyp
      1. Three or more adenomatous polyps
      2. Adenomatous polyp >1 cm
      3. Polyp biopsy consistent with high grade or villous changes
    2. Factors suggesting lower risk of future adenomatous polyp
      1. High quality baseline exam (see Colon Cancer Screening with Colonoscopy)
      2. Fewer than 3 adenomatous polyps
      3. Small adenomatous polyps <1 cm
      4. No high grade or villous changes
      5. Adenomatous polyps removed completely (not piecemeal)
    3. References
      1. Atkin (1992) N Engl J Med 326:658
  3. Evaluation: Post-polypectomy Surveillance
    1. Small colorectal hyperplastic polyps (except hyperplastic polyposis syndrome)
      1. Next Colonoscopy in 10 years (same as general population)
    2. Small tubular adenomas (<1 cm), few (1-2) and low-grade dysplasia
      1. Next Colonoscopy in 5-10 years
    3. Numerous adenomas (3-10) or larger adenoma (>1 cm) or high grade dysplasia
      1. Polyp removed completely
        1. Subsequent Colonoscopy #1: 3 years
        2. Subsequent Colonoscopy #2: 5 years
          1. As long as Colonoscopy #1 showed only 1-2, small (<1 cm) low grade lesions
      2. Polyp removed piecemeal
        1. Subsequent Colonoscopy #1: 2-6 months
        2. Subsequent Colonoscopy #2: Per endoscopists discretion
    4. References
      1. Winawer (2006) Ca Cancer J Clin 56:143
  4. Management: Sessile Serrated Adenomatous Colonic Polyp
    1. Newly defined as serrated hyperplastic polyp
    2. Must be completely excised and monitored as with adenomatous polyps
    3. Characteristics
      1. Typically larger than 1 cm
      2. Occurs in right colon in 75% of patients
      3. More common in women (65%)
      4. Accounts for 9% of all colonic polyps
    4. References
      1. Larson (2008) Mayo Selected Topics in Internal Medicine, Lecture
      2. Snover (2005) Am J Clin Path 124:380
      3. Spring (2006) Gastroenterology 131:1400

Colonic Polyps (C0009376)

Definition (MSH)Discrete tissue masses that protrude into the lumen of the COLON. These POLYPS are connected to the wall of the colon either by a stalk, pedunculus, or by a broad base.
Definition (NCI)Abnormal growths of tissue in the lining of the bowel. Polyps are a risk factor for colon cancer.
Definition (CSP)adenomatous colon polyps are considered to be precursor lesions of colon cancer.
Definition (NCI)This is a descriptive term referring of a mass of tissue that bulges or projects into the lumen of the colon. The mass is macroscopically visible and may either have a broad base attachment to the colon wall, or be on a pedunculated stalk. These may be benign or malignant.
ConceptsAnatomical Abnormality (T190)
ICD9V18.51
MSHD003111
Englishcolon polyp, colon polyps, Colonic Polyp, Colonic Polyps, FAMILY HX COLONIC POLYPS, Polyp of colon, Polyp of the Colon
FrenchPolype du colon
ItalianPolipo del colon
Spanishpolipo colonico, polipo de colon
Parent ConceptsColonic Neoplasms (C0009375), [V]Family history of digestive disorder (C0496716), Intestinal Polyps (C0021846), Polyp of large intestine (C0949059), Colonic Diseases (C0009373), Mass of colon (C1960177)
SourcesCOSTAR, CSP, DXP, ICD9CM, MEDLINEPLUS, MSH, MTH, MTHMST, MTHMSTFRE, MTHMSTITA, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Adenomatous colonic polyps (C0850572)

ConceptsNeoplastic Process (T191)
EnglishAdenoma of Colon, Adenoma of the Colon, Adenomatous colonic polyps, Adenomatous Polyp of Colon, Adenomatous Polyp of the Colon, Colon Adenoma, Colon Adenomatous Polyp, Colonic Adenoma, Colonic Adenomatous Polyp
Parent ConceptsColonic Neoplasms (C0009375), Adenoma of large intestine (C1302401)
SourcesDXP, NCI, OMIM
Derived from the NIH UMLS (Unified Medical Language System)



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