It could represent a hyperplastic or adenomatous polyp at this stage. Hence it is usually removed by the endoscopist. This 5mm polyp is a common finding on colonic evaluation and at this size is a benign abnormality. Histological examination is essential to make the distinction.Ġ0362c02 colon large bowel mass polyp multiple polyps adenomatous polyps hyperplastic polyps grosspathology Courtesy Barbara Banner MD Ashley Davidoff MD Their size smoothness and color would favor hyperplastic polyps but their location in the transverse colon would favor adenomatous polyps. The polyps overlaid in dark green, one being the same color of the mucosa and rthe second lighter than the mucosa could represent hyperplastic or adenomatous polyps. Based on the size and lobular surface, it is very likely that the polyps overalid in light green are adenomatous polyps and are likely to be tubular adenomas. This path specimen shows five polyps on the surface of the colonic mucosa. colon large bowel fx polyp fx sawtooth pattern fx hyperplasia dx hyperplastic polyps histopathology Courtesy Barbara Banner MD 12307b01 These polyps are typically 2 or 3 mm in diameter. The characteristic histology is simply hyperplasia of the epithelium of existing crypts with infoldings, creating a “sawtooth” pattern in the epithelium. The right image shows a photomicrograph at low power, showing a hyperplastic polyp of the colon. This is a low power photo micrograph of normal colon mucosa illustrating extremely orderly, rigid, “test tube”-like arrangement of the straight tubular glands which comprise the colonic crypts. The left image shows a normal colonic mucosa. Nomal (left) and Hyperplastic Polyp (right) They are usually diagnosed histologically after removal at colonoscopy, and are thus coincidentally treated. Their cause likely relates to diet and environmental factors, since they are commonly seen in Western cultures, and as small lesions, they have no definite known malignant potential. They are usually the same color or perhaps lighter than the surrounding mucosa. The hyperplastic polyps are usually small (<6mm) and have no macroscopic features that would enable the endoscopist to distinguish them from adenomatous polyps. It is the most common polyp in the colon and represents about 70-90% of polyps identified. A hyperplastic polyp is a proliferation and overgrowth of normal mucosal cells, and is characterized as a small sessile lesion, commonly located in the distal sigmoid and rectum.
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