Polyp (medicine)



Colon polyps
Classification and external resources

Polyp of sigmoid colon as revealed by colonoscopy. Approximately 1 cm in diameter. The polyp was removed by snare cautery
ICD-10 K63.5 & various
MedlinePlus 000266
eMedicine med/414
MeSH C23.300.825

A polyp is an abnormal growth of tissue projecting from a mucous membrane. If it is attached to the surface by a narrow elongated stalk it is said to be pedunculated. If no stalk is present it is said to be sessile. Polyps are commonly found in the colon, stomach, nose, sinus(es), urinary bladder and uterus. They may also occur elsewhere in the body where mucous membranes exist like the cervix[1] and small intestine.

Contents

Colorectal polyp

Colon polyps are not commonly associated with symptoms. Occasionally rectal bleeding, and on rare occasions pain, diarrhea or constipation may occur because of colon polyps. Colon polyps are a concern because of the potential for colon cancer being present microscopically and the risk of benign colon polyps transforming over time into malignant ones. Since most polyps are asymptomatic, they are usually discovered at the time of colon cancer screening with either digital rectal exam (DRE), flexible sigmoidoscopy, Barium enema, colonoscopy or virtual colonoscopy. The polyps are routinely removed at the time of colonoscopy either with a polypectomy snare (first description by P. Deyhle, Germany, 1970[2]) or with biopsy forceps. If an adenomatous polyp is found with flexible sigmoidoscopy or if a polyp is found with any other diagnostic modality, the patient must undergo colonoscopy for removal of the polyp(s). Even though colon cancer is usually not found in polyps smaller than 2.5 cm, all polyps found are removed since the removal of polyps reduces the future likelihood of developing colon cancer. When adenomatous polyps are removed, a repeat colonoscopy is usually performed in three to five years.

Most colon polyps can be categorized as sporadic.

Inherited polyposis syndromes

Micrograph of a Peutz-Jeghers colonic polyp - a type of hamartomatous polyp. H&E stain.

Non-inherited polyposis syndromes

Types of colon polyps

Endometrial polyp

An endometrial polyp or uterine polyp is a polyp or lesion in the lining of the uterus (endometrium) that takes up space within the uterine cavity. Commonly occurring, they are experienced by up to 10% of women.[3] They may have a large flat base (sessile) or be attached to the uterus by an elongated pedicle (pedunculated).[3][4] Pedunculated polyps are more common than sessile ones.[5] They range in size from a few millimeters to several centimeters.[4] If pedunculated, they can protrude through the cervix into the vagina.[3][6] Small blood vessels may be present in polyps, particularly large ones.[3]

Nasal polyp

Cervical polyp

A cervical polyp is a common benign polyp or tumor on the surface of the cervical canal.[7] They can cause irregular menstrual bleeding or increased pain but often show no symptoms.[3] Treatment consists of simple removal of the polyp and prognosis is generally good.[8] About 1% of cervical polyps will show neoplastic change which may lead to cancer.[9] They are most common in post-menstrual, pre-menopausal women who have given birth.[10]

Footnotes

  1. ^ Weschler, Toni (2002). Taking Charge of Your Fertility (Revised ed.). New York: HarperCollins. pp. 227–8, 330. ISBN 0-06-093764-5. 
  2. ^ Deyhle P (1980). "Results of endoscopic polypectomy in the gastrointestinal tract". Endoscopy (Suppl): 35–46. PMID 7408789. 
  3. ^ a b c d e Bates, Jane (2007). Practical Gynaecological Ultrasound. Cambridge University Press. p. 65. ISBN 1900151510. http://www.google.co.uk/books?id=oZ3RYlRAoxgC&pg=PP1&d. 
  4. ^ a b "Uterine polyps". MayoClinic.com. 2006-04-27. http://www.mayoclinic.com/health/uterine-polyps/DS00699/DSECTION=1. Retrieved 2007-10-20. 
  5. ^ Sternberg, Stephen S.; Stacey E. Mills, Darryl Carter (2004). Sternberg's Diagnostic Surgical Pathology. Lippincott Williams & Wilkins. p. 2460. ISBN 0781740517. http://www.google.co.uk/books?id=ko3Hew4xaj4C&d. 
  6. ^ "Dysmenorrhea: Menstrual abnormalities". Merck Manual of Diagnosis and Therapy. 2005. http://www.merck.com/mmpe/sec18/ch244/ch244d.html. Retrieved 2007-10-20. 
  7. ^ Boon, Mathilde E.; Albert J. H. Suurmeijer (1996). The Pap Smear. Taylor & Francis. p. 87. ISBN 3718658577. http://books.google.com/books?id=umcl4R3sp2AC&pg=PA87&d. 
  8. ^ MedlinePlus Encyclopedia Cervical polyps
  9. ^ Tillman, Elizabeth. "Short Instructor Materials" (PDF). Centers for Disease Control and Prevention. http://72.14.205.104/search?q=cache:7uWWuX7sq-4J:www.cdc.gov/DES/hcp/resources/materials/clinician_short_inst.pdf+%22cervical+polyp%22&hl=en&ct=clnk&cd=9&gl=uk. Retrieved 2007-10-21. 
  10. ^ Bosze, Peter; David M. Luesley (2004). Eagc Course Book on Colposcopy. Informa Health Care. p. 66. ISBN 9630073560. http://books.google.com/books?id=bg6FxsY1xTUC&pg=PA66&d. 

External links