colonic polyp

WordNet

1. the basic unit of money in Costa Rica; equal to 100 centimos (同)Costa Rican colon
2. the basic unit of money in El Salvador; equal to 100 centavos (同)El Salvadoran colon
3. a punctuation mark (:) used after a word introducing a series or an example or an explanation (or after the salutation of a business letter)
4. the part of the large intestine between the cecum and the rectum; it extracts moisture from food residues before they are excreted
5. a small vascular growth on the surface of a mucous membrane (同)polypus
6. one of two forms that coelenterates take (e.g. a hydra or coral): usually sedentary with a hollow cylindrical body usually with a ring of tentacles around the mouth; "in some species of coelenterate, polyps are a phase in the life cycle that alternates with a medusoid phase"
7. of or relating to the colon

PrepTutorEJDIC

1. コロン(:)(句読点の一種で,文中においてセミコロン以上を分離を示すほか,対照,例証,引用文などを示すのに用いる)
2. (大腸の)結腸[部]
3. ポリプ(ヒドラ,イソギンチャクなどの生物)・ポリープ(鼻などの粘膜にできるおでき)
4. =polytechnic
5. 《話》政治家

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/04 21:50:56」(JST)

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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

Gross appearance of a colectomy specimen containing two colorectal polyps and one invasive colorectal carcinoma

Micrograph of a tubular adenoma, the most common type of dysplastic polyp in the colon.

Micrograph of a sessile serrated adenoma. H&E stain.

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

Micrograph of a tubular adenoma – dysplastic epithelium (dark purple) on left of image; normal epithelium (blue) on right. H&E stain.

Micrograph of a villous adenoma. These polyps are considered to have a high risk of malignant transformation. H&E stain.

A colorectal polyp is a polyp (fleshy growth) occurring on the lining of the colon or rectum. Untreated colorectal polyps can develop into colorectal cancer.

Colorectal polyps are often classified by their behaviour (i.e. benign vs. malignant) and/or etiology (e.g. as a consequence of inflammatory bowel disease). They may be benign (e.g. hyperplastic polyp), pre-malignant (e.g. tubular adenoma) or malignant (e.g. colorectal adenocarcinoma).

Types

The most common general classification is:

• hyperplastic,
• neoplastic (adenomatous & malignant),
• hamartomatous and,
• inflammatory.

Hyperplastic polyp

Most hyperplastic polyps are found in the distal colon and rectum. They have no malignant potential , which means that they are no more likely than normal tissue to eventually become a cancer.

Hyperplastic polyps are serrated polyps. Hyperplastic polyps have three histologic patterns of growth: microvesicular, goblet cell and mucin poor.

Hyperplastic polyposis syndrome is a rare condition that has been defined by the World Health Organization as either:

1. Five or more hyperplastic polyps proximal to the sigmoid colon, with two polyps greater than 10mm in diameter; or
2. Any number of hyperplastic polyps proximal to the sigmoid colon in a person with a first degree relative who has hyperplastic polyposis syndrome; or
3. More than 30 hyperplastic polyps of any size throughout the colon and rectum.

Although thought to exhibit no malignant potential it has been shown that hyperplastic polyps on the right side of the colon do exhibit a malignant potential. This occurs through multiple mutations which effect the DNA-mismatch-repair pathways. As such DNA mutations during replication are not repaired. This leads to microsatellite instability which can eventually lead to malignant transformation in polyps on the right side of the colon.

Neoplastic polyp

A neoplasm is a tissue whose cells have lost its normal differentiation. They can be either benign growths or malignant growths. The malignant growths can either have primary or secondary causes.

Adenomas

Neoplastic polyps of the bowel are often benign hence called adenomas. An adenoma is tumor glandular tissue, that has not (yet) gained the properties of a cancer.

The common adenomas of the colon are the tubular, tubulovillous, villous, and sessile serrated (SSA).

As is evident from their name, sessile serrated and traditional serrated adenomas (TSAs) have a serrated appearance and can be difficult to distinguish microscopically from hyperplastic polyps. Making this distinction is important, however, since SSAs and TSAs have the potential to become cancers, while hyperplastic polyps do not.

The villous subdivision are associated with the highest malignant potential because they generally have the largest surface area. (This is because the villi are projections into the lumen and hence have a bigger surface area.) However, villous adenomas are no more likely than tubular or tubulovillous adenomas to become cancerous if their sizes are all the same.

Hamartomatous polyp

They are growths, like tumours found in organs as a result of faulty development. They are normally made up of a mixture of tissues. They grow at the normal rate of the host tissue and rarely cause problems such as compression. A common example of a hamartomatous lesion is a strawberry naevus. Hamartomatous polyps are often found by chance; occurring in syndromes such as Peutz-Jegher Syndrome or Juvenile Polyposis Syndrome.

Peutz-Jeghers syndrome is associated with polyps of the GI tract and also increased pigmentation around the lips, genitalia, buccal mucosa feet and hands. People are often diagnosed with Peutz-Jegher after presenting at around the age of 9 with an intussusception. The polyps themselves carry little malignant potential but because of potential coexisting adenomas there is a 15% chance of colonic malignancy.

Juvenile polyps are hamartomatous polyps which often become evident before twenty years of age, but can also be seen in adults. They are usually solitary polyps found in the rectum which most commonly present with rectal bleeding. Juvenile polyposis syndrome is characterised by the presence of more than five polyps in the colon or rectum, or numerous juvenile polyps throughout the gastrointestinal tract, or any number of juvenile polyps in any person with a family history of juvenile polyposis. People with juvenile polyposis have an increased risk of colon cancer.

Inflammatory polyp

These are polyps which are associated with inflammatory conditions such as Ulcerative Colitis and Crohns disease.

Symptoms

Colorectal polyps are not usually associated with symptoms. When they occur, symptoms include rectal bleeding, bloody stools, abdominal pain and fatigue. A change in bowel habits may occur including constipation and diarrhoea. Occasionally, if a polyp is big enough to cause a bowel obstruction, there may be nausea, vomiting and severe constipation.

Screening and diagnosis

Colorectal polyps can be detected using a faecal occult blood test, flexible sigmoidoscopy, colonoscopy, virtual colonoscopy, digital rectal examination, barium enema or a pill camera.

When does a polyp become a problem?

Malignant potential is associated with

• degree of dysplasia
• Type of polyp (e.g. villous adenoma):
  • Tubular Adenoma: 5% risk of cancer
  • Tubulovillous adenoma: 20% risk of cancer
  • Villous adenoma: 40% risk of cancer
• Size of polyp:
  • <1 cm =<1% risk of cancer^{[citation needed]}
  • 1 cm=10%risk of cancer^{[citation needed]}
  • 2 cm=15%risk of cancer^{[citation needed]}

Normally an adenoma which is greater than 0.5 cm is treated

Treatment

Polyps can be removed during a colonoscopy or sigmoidoscopy using a wire loop that cuts the stalk of the polyp and cauterises it to prevent bleeding. Many "defiant" polyps — large, flat, and otherwise laterally spreading adenomas — may be removed endoscopically by a technique called endoscopic mucosal resection (EMR), which involves injection of fluid underneath the lesion to lift it and thus enable facilitate surgical excision. These techniques may be employed as an alternative to a much-more-invasive colectomy.

Structure

Polyps are either pedunculated (attached to the intestinal wall by a stalk) or sessile (grow directly from the wall).

See also

Polyp table

Additional images

• Microvesicular hyperplastic polyp. H&E stain.

• Microvesicular hyperplastic polyp. H&E stain.

• Traditional serrated adenoma. H&E stain.

References

External links

• "How I Do It" — Removing large or sessile colonic polyps. Dr. Brian Saunders MD FRCP; St. Mark’s Academic Institute; Harrow, Middlesex, UK. Retrieved April 9, 2008.
• Villous Adenoma - Medscape
• http://www.netdoctor.co.uk/diseases/facts/colonpolyps.htm
• http://www.clevelandclinic.org/registries/inherited/jp.htm
• Adenomas (serrated, tubular, tubulovillous, villous) and hyperplastic polyps
• Case of Tubulovillous Adenoma
• Tubulovillous adenoma, Colon
• Polyps explanation and risks

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 大腸ポリープ患者に対するアプローチ approach to the patient with colonic polyps
• 2. 大きな結腸ポリープの内視鏡的切除 endoscopic removal of large colonic polyps
• 3. 成人における大腸内視鏡検査の概要 overview of colonoscopy in adults
• 4. 患者情報：大腸ポリープ（詳細） colon polyps beyond the basics
• 5. 大腸癌のスクリーニング：平均的リスクの患者における戦略 screening for colorectal cancer strategies in patients at average risk

English Journal

• Association between serum HbA1c levels and adenomatous polyps in patients with the type 2 diabetes mellitus.

• Huang X1, Fan Y, Zhang H, Wu J, Zhang X, Luo H.
• Minerva endocrinologica.Minerva Endocrinol.2015 Sep;40(3):163-7. Epub 2014 Jul 8.
• AIM: This study aimed to determine whether serum hemoglobin A1c (HbA1c) levels are associated with colonic adenomatous polyps (APs) in patients with type 2 diabetes mellitus.METHODS: Four hundred sixty-four patients (262 men and 202 women) with type 2 diabetes mellitus and colorectal adenomas admitt
• PMID 25003225

• Colorectal cancer screening by colonoscopy: Putting it into perspective.

• Vleugels JL1, van Lanschot MC1, Dekker E1.
• Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.Dig Endosc.2015 Aug 10. doi: 10.1111/den.12533. [Epub ahead of print]
• Implementation of nationwide screening programs aims to decrease the disease burden of colorectal cancer (CRC) in the general population. Globally, most population screening programs for CRC are performed by either fecal occult blood test, flexible sigmoidoscopy or colonoscopy. For screening program
• PMID 26257272

• Black raspberries suppress colonic adenoma development in ApcMin/+ mice: relation to metabolite profiles.

• Pan P1, Skae CW1, Wang HT1, Stirdivant SM2, Young MR3, Oshima K4, Stoner GD1, Lechner JF1, Huang YW5, Wang LS6.
• Carcinogenesis.Carcinogenesis.2015 Aug 5. pii: bgv117. [Epub ahead of print]
• Freeze-dried black raspberries (BRBs) have demonstrated chemopreventive effects in a dietary intervention trial with human colorectal cancer patients. The aim of this study was to investigate BRB-caused metabolite changes using the ApcMin/+ mouse as a model of human colorectal cancer. Wild-type (WT)
• PMID 26246425

Japanese Journal

• 著明な脂肪組織の増生を伴った十二指腸水平部のmuco-submucosal elongated polypの1例

• 吉水 祥一,柄川 悟志,土居 哲,水本 塁,戸田 万生良,中村 剛之,糸瀬 一陽,中塚 伸一,八尾 隆史,萩原 秀紀
• 日本消化器内視鏡学会雑誌 57(3), 235-240, 2015
• … を認め，貧血の原因と考えられたため内視鏡的ポリープ切除術を施行した．組織学的に病変は正常粘膜に覆われ，粘膜から粘膜下層に拡張した毛細血管とリンパ管の増生する疎性結合組織を認めた．Colonic muco-submucosal elongated polyp（CMSEP）と同様の所見であり，十二指腸のMSEPと診断した．十二指腸のMSEPは稀な疾患であり，本例では病変の内部に脂肪組織の著明な増生を認めることが特徴的であった． …
• NAID 130005061492

• 大腸内視鏡検査で偶然発見された無症候性大腸アニサキス症の1例

• 佐々木 賢一,芹澤 宏,中野 雅,加藤 裕佳子,小林 拓,清水 清香,常松 令,渡辺 憲明,土本 寛二,日比 紀文,末盛 友浩,森永 正二郎
• Progress of Digestive Endoscopy 85(1), 104-105, 2014
• … A 42-year-old-woman who had being undergoing periodic colonoscopy since 2008 as follow-up for a colonic polyp, underwent colonoscopy at our hospital in June 2013. … Colonic anisakiasis (similar to gastric anisakiasis) is treated by early colonoscopic removal of Anisakis larvae. …
• NAID 130004985546

• 内反結腸憩室の1例

• 柿本 年春,辻 忠男,桂 英之,金田 浩幸,篠崎 博志,水谷 友美,三浦 邦治,宮永 亮一,松波 幸寿
• Progress of Digestive Endoscopy 84(1), 176-177, 2014
• … The patient was diagnosed as having colonic diverticulitis and treated with antibiotics. … A month later, total colonoscopy was performed, which showed multiple colonic diverticula in the ascending colon and a polypoid lesion at the same site. … The polypoid lesion was covered with normal colonic mucosa and the top of the lesion was reddish and slightly depressed. …
• NAID 130004985504

Related Links

• Colorectal polyp - Wikipedia, the free encyclopedia

Polyp of sigmoid colon as revealed by colonoscopy. Approximately 1 ... Micrograph of a tubular adenoma, the most common type of dysplastic polyp in the colon. ... Micrograph of a Peutz-Jeghers colonic polyp - a type of hamartomatous polyp.

• Colonic Polyps

21 Jun 2012 ... Colonic polyps are slow-growing overgrowths of the colonic mucosa that carry a small risk (< 1%) of becoming malignant. However, because colonic polyps are highly prevalent in the general population (especially with ...

Related Pictures

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★リンクテーブル★

リンク元	「大腸ポリープ」
関連記事	「colonic」「poly」「colon」

「大腸ポリープ」

　　[★]

英

colonic polyp, polyp of large intestine, polyp of the colon

関

結腸ポリープ、大腸ポリポーシス

概念

• (広義)大腸の管腔内に突出する限局性隆起。腫瘍性から非腫瘍性のものを含む。
• (狭義)上皮性増殖からなる隆起。良性のものを指して言うことが多い。

分類

• 1. 腫瘍性ポリープ

• 上皮性：大腸腺腫(腺管腺腫(80%)、腺管絨毛腺腫(20%)、絨毛腺腫)。(遺伝性)大腸腺腫症(家族性大腸ポリポーシス、Gardner症候群、Turcot症候群
• 非上皮性：腸管リンパ腫など

• 2. 非腫瘍性ポリープ

• 過誤腫性：過誤腫性ポリープ(Peutz-Jeghers症候群、若年性ポリープ、Cowden病)
• 炎症性：炎症性ポリープ、良性リンパ濾胞性ポリープ
• その他：過形成性ポリープ、Cronkhite-Canada症候群？

大腸ポリープ全体のなかで大腸腺腫は80%を占める。

疫学

• 40歳代より漸増。50歳以上でよく見られる(SSUR.544)。
• 男女比2:1

病態

• 直腸(50%)・S状結腸(20%)に好発。

病理

• 無茎性(Is)が最も多い。有茎性(Ip)、亜有茎性(Isp)など

症状

• 無症状のことが多いが、まれに消化管出血をきたしうる。しかし、下血を来すほどの出血はしない。

治療

• 内視鏡的ポリペクトミー、内視鏡的粘膜切除術

「colonic」

　　[★]

• 結腸の、大腸の

関

colon、large bowel、large intestine

　

「poly」

　　[★]

• comb form.

• ポリ、多

関

multi

　

「colon」

　　[★] 結腸