Introduction There are 3 types of benign polyps (hamartomas) hyperplastic polyp most common type in adults often rectosigmoid sawtoothed appearance does NOT predispose to malignancy juvenile polyps most common type in children often rectosigmoid Peutz-Jeghers polyposis There are 3 types of neoplastic polyps (adenomas) tubular adenoma most common polyp usually pedunculated (stalked) tubulovillous adenoma usually pedunculated (stalked) villous adenoma greatest malignant potential usually sessile may secrete protein and K+-rich mucus may involve Familial Adenomatous Polyposis Presentation Sympoms rectal bleeding polyp prolapse from rectum Evaluation Sigmoidoscopy / colonoscopy Labs villous adenoma may show hypokalemia and hypoalbuminemia Differential Polyposis syndromes Juvenile polyposis AD inheritance multiple juvenile polyps in GI tract ↑ risk of adenocarcinoma Cronkhite-Canada syndrome consists of juvenile polyposis with fingernail dystrophy Prognosis, Prevention, and Complications Malignancy risk ↑ by ↑ size ↑ villous histology villous = villainous ↑ epithelial dysplasia
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