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Epithelial Polyps

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Atlas of Intestinal Pathology

Part of the book series: Atlas of Anatomic Pathology ((AAP))

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Abstract

The vast majority of polyps arising in the small and large intestines are derived from epithelial cells. These are routinely sampled by endoscopists during screening and diagnostic procedures, and hence they comprise a large proportion of the work done by pathologists. The proper diagnosis of intestinal polyps is required to gauge the risk of subsequent intestinal malignancy, either through the enumeration and classification of premalignant polyps, or less commonly through the identification of polyps that may alert clinicians to an underlying neoplastic syndrome. Although polyps from the small bowel are relatively rare specimens, most of the principles from the colorectum can be extended to this site.

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References

  1. Jepsen JM, Persson M, Jakobsen NO, Christiansen T, Skoubo-Kristensen E, Funch-Jensen P, et al. Prospective study of prevalence and endoscopic and histopathologic characteristics of duodenal polyps in patients submitted to upper endoscopy. Scand J Gastroenterol. 1994;29:483–7.

    Article  CAS  Google Scholar 

  2. Kelly JK, Langevin JM, Price LM, Hershfield NB, Share S, Blustein P. Giant and symptomatic inflammatory polyps of the colon in idiopathic inflammatory bowel disease. Am J Surg Pathol. 1986;10:420–8.

    Article  CAS  Google Scholar 

  3. Chetty R, Bhathal PS, Slavin JL. Prolapse-induced inflammatory polyps of the colorectum and anal transitional zone. Histopathology. 1993;23:63–7.

    Article  CAS  Google Scholar 

  4. Meniconi RL, Caronna R, Benedetti M, Fanello G, Ciardi A, Schiratti M, et al. Inflammatory myoglandular polyp of the cecum: case report and review of literature. BMC Gastroenterol. 2010;10:10.

    Article  Google Scholar 

  5. Shaco-Levy R, Jasperson KW, Martin K, Samadder NJ, Burt RW, Ying J, Bronner MP. Morphologic characterization of hamartomatous gastrointestinal polyps in Cowden syndrome, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Hum Pathol. 2016;49:39–48.

    Article  Google Scholar 

  6. Iqbal U, Chaudhary A, Karim MA, Anwar H, Merrell N. Cronkhite-Canada syndrome: a rare cause of chronic diarrhea. Gastroenterology Res. 2017;10:196–8.

    Article  Google Scholar 

  7. Jansen M. Mucosal prolapse in the pathogenesis of Peutz-Jeghers polyposis. Gut. 2006;55:1–5.

    Article  CAS  Google Scholar 

  8. Sethi A, Anspach-Hanson J. A morphologic reappraisal of endoscopically but not histologically apparent polyps and the emergence of the overlooked goblet cell--rich hyperplastic polyp. Hum Pathol. 2015;46:1147–52.

    Article  Google Scholar 

  9. Choi EY, Appelman HD. A historical perspective and exposé on serrated polyps of the colorectum. Arch Pathol Lab Med. 2016;140:1079–84.

    Article  Google Scholar 

  10. Huang CC, Frankel WL, Doukides T, Zhou XP, Zhao W, Yearsley MM. Prolapse-related changes are a confounding factor in misdiagnosis of sessile serrated adenomas in the rectum. Hum Pathol. 2013;44:480–6.

    Article  Google Scholar 

  11. Torlakovic E, Skovlund E, Snover DC, Torlakovic G, Nesland JM. Morphologic reappraisal of serrated colorectal polyps. Am J Surg Pathol. 2003;27:65–81.

    Article  Google Scholar 

  12. Quirke P, Risio M, Lambert R, von Karsa L, Vieth M. Quality assurance in pathology in colorectal cancer screening and diagnosis—European recommendations. Virchows Arch. 2011;458:1–19.

    Article  Google Scholar 

  13. Huang CS, Farraye FA, Yang S, O’Brien MJ. The clinical significance of serrated polyps. Am J Gastroenterol. 2011;106:229–40.

    Article  Google Scholar 

  14. Snover DC. Update on the serrated pathway to colorectal carcinoma. Hum Pathol. 2011;42:1–10.

    Article  Google Scholar 

  15. Winawer SJ, Zauber AG, Fletcher RH, Stillman JS, O’Brien MJ, Levin B, US Multi-Society Task Force on Colorectal Cancer, American Cancer Society, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006;130:1872–85.

    Article  Google Scholar 

  16. Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–57.

    Article  Google Scholar 

  17. Higuchi T, Sugihara K, Jass JR. Demographic and pathological characteristics of serrated polyps of colorectum. Histopathology. 2005;47:32–40.

    Article  CAS  Google Scholar 

  18. Oka S, Tanaka S, Hiyama T, Ito M, Kitadai Y, Yoshihara M, et al. Clinicopathologic and endoscopic features of colorectal serrated adenoma: differences between polypoid and superficial types. Gastrointest Endosc. 2004;59:213–9.

    Article  Google Scholar 

  19. Snover DC, Jass JR, Fenoglio-Preiser C, Batts KP. Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept. Am J Clin Pathol. 2005;124:380–91.

    Article  Google Scholar 

  20. Lash RH, Genta RM, Schuler CM. Sessile serrated adenomas: prevalence of dysplasia and carcinoma in 2139 patients. J Clin Pathol. 2010;63:681–6.

    Article  Google Scholar 

  21. Jass JR. Serrated route to colorectal cancer: back street or super highway? J Pathol. 2001;193:283–5.

    Article  CAS  Google Scholar 

  22. Torlakovic EE, Gomez JD, Driman DK, Parfitt JR, Wang C, Benerjee T, Snover DC. Sessile serrated adenoma (SSA) vs. traditional serrated adenoma (TSA). Am J Surg Pathol. 2008;32:21–9.. Erratum in: Am J Surg Pathol. 2008;32:491

    Article  Google Scholar 

  23. Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, American Cancer Society Colorectal Cancer Advisory Group, US Multi-Society Task Force, American College of Radiology Colon Cancer Committee, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–95.

    Article  CAS  Google Scholar 

  24. East JE, Saunders BP, Jass JP. Sporadic and syndromic hyperplastic polyps and serrated adenomas of the colon: classification, molecular genetics, natural history and clinical management. Gastroenterol Clin N Am. 2008;37:25–46.

    Article  Google Scholar 

  25. Groff RJ, Nash R, Ahnen DJ. Significance of serrated polyps of the colon. Curr Gastroenterol Rep. 2008;10:490–8.

    Article  Google Scholar 

  26. Schick BA, McLean CA, Driman DK. Negative colorectal polyp biopsies: the utility of cutting deeper levels. Virchows Arch. 2015;467:635–40.

    Article  Google Scholar 

  27. Wu ML, Dry SM, Lassman CR. Deeper examination of negative colorectal biopsies. Am J Clin Pathol. 2002;117:424–8.

    Article  Google Scholar 

  28. Nash JW, Niemann T, Marsh WL, Frankel WL. To step or not to step: an approach to clinically diagnosed polyps with no initial pathologic finding. Am J Clin Pathol. 2002;117:419–23.

    Article  Google Scholar 

  29. Shi C, Scudiere JR, Cornish TC, Lam-Himlin D, Park JY, Fox MR, Montgomery EA. Clear cell change in colonic tubular adenoma and corresponding colonic clear cell adenocarcinoma is associated with an altered mucin core protein profile. Am J Surg Pathol. 2010;34:1344–50.

    Article  Google Scholar 

  30. Mahon M, Xu J, Yi X, Liu X, Gao N, Zhang L. Paneth cell in adenomas of the distal colorectum is inversely associated with synchronous advanced adenoma and carcinoma. Sci Rep. 2016;6:26129.

    Article  CAS  Google Scholar 

  31. Lin J, Goldblum JR, Bennett AE, Bronner MP, Liu X. Composite intestinal adenoma-microcarcinoid. Am J Surg Pathol. 2012;36:292–5.

    Article  Google Scholar 

  32. Tanizawa T, Seki T, Nakano M, Kamiyama R. Pseudoinvasion of the colorectal polypoid tumors: serial section study of problematic cases. Pathol Int. 2003;53:584–90.

    Article  Google Scholar 

  33. Yantiss RK, Bosenberg MW, Antonioli DA, Odze RD. Utility of MMP-1, p53, E-cadherin, and collagen IV immunohistochemical stains in the differential diagnosis of adenomas with misplaced epithelium versus adenomas with invasive adenocarcinoma. Am J Surg Pathol. 2002;26:206–15.

    Article  Google Scholar 

  34. Panarelli NC, Somarathna T, Samowitz WS, Kornacki S, Sanders SA, Novelli MR, et al. Diagnostic challenges caused by endoscopic biopsy of colonic polyps: a systematic evaluation of epithelial misplacement with review of problematic polyps from the Bowel Cancer Screening Program, United Kingdom. Am J Surg Pathol. 2016;40:1075–83.

    Article  Google Scholar 

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Authors and Affiliations

  1. Pathology and Laboratory Medicine, University of British Columbia, Royal Victoria Regional Health Centre, Barrie, ON, Canada

    Hector H. Li-Chang MD

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  1. Hector H. Li-Chang MD
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Li-Chang, H.H. (2019). Epithelial Polyps. In: Atlas of Intestinal Pathology. Atlas of Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-12379-6_1

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  • DOI: https://doi.org/10.1007/978-3-030-12379-6_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12377-2

  • Online ISBN: 978-3-030-12379-6

  • eBook Packages: MedicineMedicine (R0)

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