http://www.fpnotebook.com/
Colonic Polyp
Aka: Colonic Polyp, Adenomatous Colonic Polyp, Hyperplastic Colonic Polyp, Sessile Serrated Adenomatous Colonic Polyp
- Types
- Benign
- Hyperplastic Colonic Polyp (except the higher risk, hyperplastic polyposis syndrome)
- Inflammatory Colonic Polyp
- Malignant Potential (require complete excision and close interval follow-up)
- Adenomatous Colonic Polyp
- Sessile Serrated Adenomatous Colonic Polyp
- Interpretation
- Factors suggesting higher risk of future adenomatous polyp
- Three or more adenomatous polyps
- Adenomatous polyp >1 cm
- Polyp biopsy consistent with high grade or villous changes
- Factors suggesting lower risk of future adenomatous polyp
- High quality baseline exam (see Colon Cancer Screening with Colonoscopy)
- Fewer than 3 adenomatous polyps
- Small adenomatous polyps <1 cm
- No high grade or villous changes
- Adenomatous polyps removed completely (not piecemeal)
- References
- Atkin (1992) N Engl J Med 326:658-62
- Evaluation: Post-polypectomy Surveillance
- Small colorectal hyperplastic polyps (except hyperplastic polyposis syndrome)
- Next Colonoscopy in 10 years (same as general population)
- Small tubular adenomas (<1 cm), few (1-2) and low-grade dysplasia
- Next Colonoscopy in 5-10 years
- Numerous adenomas (3-10) or larger adenoma (>1 cm) or high grade dysplasia
- Polyp removed completely
- Subsequent Colonoscopy #1: 3 years
- Subsequent Colonoscopy #2: 5 years
- As long as Colonoscopy #1 showed only 1-2, small (<1 cm) low grade lesions
- Polyp removed piecemeal
- Subsequent Colonoscopy #1: 2-6 months
- Subsequent Colonoscopy #2: Per endoscopists discretion
- References
- Winawer (2006) Ca Cancer J Clin 56:143-59
- Management: Sessile Serrated Adenomatous Colonic Polyp
- Newly defined as serrated hyperplastic polyp
- Must be completely excised and monitored as with adenomatous polyps
- Characteristics
- Typically larger than 1 cm
- Occurs in right colon in 75% of patients
- More common in women (65%)
- Accounts for 9% of all Colonic Polyps
- References
- Larson (2008) Mayo Selected Topics in Internal Medicine, Lecture
- Snover (2005) Am J Clin Path 124:380
- Spring (2006) Gastroenterology 131: 1400-7