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At least 19 recordsLinked to original sources
PubMed1977

Nature and significance of colonic polyps.

The concept of inevitable premalignancy in all adenomatous polyps of the colon was challenged as early as 1958, and since that time much debate has centered about the malignant potential of adenomatous polyps of the colon. Current thinking indicates that the majority of colonic polyps fall into one of four categories: hyperplastic, villous adenoma, adenomatous, and villoglandular. Analysis of the present series of 387 colonic polyps removed endoscopically indicates that the villoglandular group has a notable malignant potential, and that the pure adenomatous polyp probably carries a minimal malignant threat. The present series does not challenge the accepted concept that hyperplastic polyps are of no malignant potential, and that villous adenomas are quite frequently malignant at the time of diagnosis.

Colonic Neoplasms↗
PubMedDate not supplied

Metastasis from a pedunculated adenomatous colonic polyp with focally invasive carcinoma: report of a case.

A patient who had metastasis from a focus of invasive carcinoma confined to the head of an otherwise benign pedunculated adenomatous polyp of the sigmoid colon is described. That only 20 such cases have been reported previously attests to the rarity of this phenomenon. Because the morbidity and mortality of radical surgery far outweigh the liklihood of metastasis from such foci of invasive carcinoma in pedunculated adenomatous colonic polyps, local removal is recommended.

Adenocarcinoma↗
PubMed1978

Malignancy of colonic polyps. Diagnosis and management.

The risk of malignant degeneration of colonic polyps has traditionally rested on various roentgenographic criteria such as broad base, irregular surface and size larger than 1 cm. With the aim of facilitating the choice of treatment of colonic polyps, an appraisal is made of the morphology of 200 polyps removed from 154 patients. The results of barium enema and double contrast techniques are compared with those obtained at colonoscopy. Radiography is found to have considerable shortcomings in evaluation of the appearance of the polyp. As the correlation of the gross morphology of the polyp of histology is weak endoscopic polypectomy should be performed whenever possible.

Colon↗
PubMed1977

Localization by immunoperoxidase and estimation by radioimmunoassay of carcinoembryonic antigen in colonic polyps.

A 3-layer immunoperoxidase technique was used to demonstrate carcinoembryonic antigen (CEA) in colonic polyps from patients with or without previous or concurrent malignancy. CEA was demonstrated in a higher percentage of the polyps received as fresh specimens that were rapidly frozen and fixed in ethanol, than in formalin-fixed, paraffin-embedded sections. Tissue CEA content of both colonic carcinomas and polyps was determined by radioimmunoassay, and it was found that benign colonic tumours had levels of tissue CEA comparable to colonic cancer, indicating that CEA concentration in a tumour does not reflect its grade of malignancy. In fact, in one case in which both colonic cancer and polyps were removed, the polyps had the higher quantities of tissue CEA. Further, tissue CEA concentration of a polyp was not dependent on its size or location. Studying the titres of circulating CEA in these patients revealed an elevation of plasma CEA in one-third of the patients with only colonic polyps, whilst the patients with cancer all had increased titres.

Carcinoembryonic Antigen↗
PubMed1978

Colon polyps, sebaceous cysts, gastric polyps, and malignant brain tumor in a family.

A unique family with a distinct syndrome of adenomatous colonic polyps and sebaceous cysts without osseous or soft tissue abnormalities is presented. One member had benign gastric polyps limited to the upper half of the stomach and another had a medulloblastoma of the cerebellum. A histologic feature in the colon of the propositus was the presence of atypical epithelium in flat mucosa as well as in the colonic polyps.

Adolescent↗
PubMed1976

Colonic polyps: antecedent- or associated-lesions of large bowel cancer.

Many pathologists, gastroenterologists, and oncologists agree that villous (papillary) adenomas of the large bowel are at risk for the development of large bowel cancer. The role of adenomatous polyps (tubular adenomas) in the genesis of large bowel cancer is not a point of agreement. Future studies with molecular biologic techniques of colon polyps and adjacent mucosa and of the colonic mucosa of animals under treatment with colon carcinogens may clarify the role of colon polyps and other factors in the genesis of large bowel cancer. Polyps larger than 1.0 cm should be removed thrugh the proctosigmoidscope or the colonoscope.

Adenocarcinoma↗
PubMed1979

Morphology, anatomic distribution and cancer potential of colonic polyps.

The concept of a polyp-cancer sequence is assuming increasing credibility as a factor in the development of colorectal cancer. Colonoscopy permits most colonic polyps to be endoscopically removed and studied pathologically. Of various polyp types encountered in the colon only neoplastic polyps are regarded as having malignant potential. Neoplastic polyps include tubular adenomas (formerly, adenomatous polyps), villous adenomas and villotubular adenomas (formerly, mixed or tuboglandular polyps). Cancerous changes must penetrate the muscularis mucosae for a polyp to be regarded as clinically malignant. The present report analyzes a series of 5,786 adenomas from over 7,000 polyp endoscopically removed. The largest number of each type of adenoma presented in the sigmoid colon, followed by the descending colon in terms of frequency. In all zones tubular adenomas were most common, villous least. Abnormal cellular change, from dysplasia to carcinoma in situ to invasive cancer was most frequently found in the sigmoid colon and, in all colon sectors, increased as the villous componency of the polyp increased. However, all categories of neoplastic polyps showed malignant changes. Polyp size, long recognized as a factor, was shown to be importantly related to malignant change, but invasive cancer was found even in polyps less than 1 cm in diameter. In addition, the incidence of malignancy rose parallel to the frequency of synchronous and metachronous polyps. A vigorous program for detection and endoscopic removal of colorectal polyps is recommended as a means of reducing the incidence of colorectal cancer.

Adenoma↗
PubMed1977

Value of a single forceps biopsy of colonic polyps.

The accuracy of colonoscopic biopsies in predicting the histological diagnosis of colonic polyps removed at colonoscopy or at laparotomy was studied. Forty-two patients were colonoscoped before the removal of 50 polyps. A single fractional biopsy was obtained from each lesion with the standard endoscopic biopsy forceps and was compared to the final histological diagnosis of each excised lesion. Thirteen (26%) of the singular fractional biopsies did not demonstrate the significant histological features of the excised polyps. These tiny biopsies do not adequately represent the entire polyp. Moreover, the 2- to 3-mm size of the biopsy does not permit the study of the central submucosal area of the polyp stalk, the critical area for assessing invasive malignancy. Histological examination of a completely excised polyp is essential for accurate diagnosis and appropriate therapy.

Biopsy↗
PubMed1979

Intestinal lymphangiectasia and colonic polyps: surgical intervention.

A 36-mo-old boy with Milroy's Disease, intestinal lymphangiectasia, and an exudative enteropathy (EE), was shown to have four colonic polyps. A large adenomatous polyp was excised from the transverse colon in an effort to control his EE and hypoalbuminemia (1.95 g/dl). His clinical status then stabilized until age 50 mo when there was a marked exacerbation of his EE. Medical management resulted in a temporary stabilization of his condition. A partial resection (40 cm) of the visually worse affected jejunum was performed. There was no improvement in the EE as measured by 51Cr-tagged albumin study; however, his clinical response was dramatic. In the 10 mo since surgery, he has been well and has shown catchup in linear growth.

Child, Preschool↗
PubMed1979

Pathogenesis of colonic polyps in multiple juvenile polyposis: report of a case associated with gastric polyps and carcinoma of the rectum.

The pathogenesis of juvenile polyps of the colon was studied in a patient with multiple juvenile polyposis who underwent proctocolectomy for rectal carcinoma and antrectomy for associated polyps of the stomach. Numerous polyps up to 3 cm in diameter were present predominantly in the cecum and rectum, and in addition there was an adenocarcinoma in the rectum. Microscopically there were five categories of lesions: 1) Hyperplastic epithelial foci and small hyperplastic polyps; 2) Typical Juvenile polyps; 3) Juvenile polyps with focal adenomatous epithelium; 4) Adenomas; and 5) and adenocarcinoma. The five categories could represent a pathogenetic sequence, beginning with epithelial hyperplasia, leading to small hyperplastic polyps which become inflamed and enlarge, forming juvenile polyps. Focal adenomatous areas which develop in some juvenile polyps might give rise to adenomas and in turn lead to carcinoma. Although juvenile polyps are generally not considered to be premalignant lesions, this case demonstrates that neoplastic changes may occur in juvenile polyps in certain individuals, and raises the possibility that these may on occasion give rise to carcinoma.

Adenocarcinoma↗
PubMed1975

[Endoscopic resection of colonic polyps. A propos of 45 polypectomies].

Endoscopic resection of polyps of the colon is, no doubt, a considerable therapeutic advance. It avoids surgical operation permits histological examination and makes simple biopsy unnecessary. It is indicated in the presence of pediculated polyps of a diameter or less than 3 cm, whatever the site of the polyp. Thus we were able to remove 45 polyps without complications. The method is not indicated in a large size polyp, sessile polyps or diffuse polyposis. The follow-up is still insufficient to assess : 1) the true risk of resection which can only be undertaken after long experience of colonoscopy ; 2) the frequency or recurrent adenomas. Endoscopic resection is at present the simplest method of detection and treatment of carcinoma in situ of the colon of which we observed four cases in our series. The problem of surgical reoperation is discussed.

Colonic Neoplasms↗
PubMed1978

[Pathology of colonic polyps].

Recent developments in the field of polyps of the colon are discussed. The WHO classification represents a definite improvement. Apart from standardization, non-neoplastic polypoid changes of varying etiology and hamartomatous polyps are clearly distinguished from neoplastic, non-malignant adenomas. The various changes are outlined briefly in their essential characteristics. Clear-cut differentiation from early invasive cancer is of considerable importance for practical therapeutic purposes. Focal carcinoma within an adenoma is referred to only if invasion through the muscularis mucosae is established, while all other changes confined to the mucosa are termed adenomas with focal epithelial atypia. With regard to the relation between adenoma and cancer of the colon, recent results on topographical distribution of adenomas through the colon are of considerable significance. From serial studies of biopsy and autopsy specimens on the one hand, and from assessment of colon carcinoma incidence compared with mortality rates in carcinomas of different localizations on the other, it is evident that special attention should be given henceforward to adenomas, possible precursors, and carcinomas in the upper segments of the colon.

Adenoma↗
PubMed1979

Diminutive colonic polyps--clinical significance and management.

Of 300 diminutive polyps (up to 5 mm) found at colonoscopy, 114 were neoplastic (37 per cent) and thus possible precursors of carcinoma. This suggests that all colonic polyps, regardless of size, should if possible be extirpated or coagulated. As polyps of this small size often escape detection roentgenologically, especially by conventional technique, colonoscopy should be extended to involve the entire colon. This is because diminutive polyps, especially of neoplastic type, are common also in the proximal part of the colon.

Adult↗
PubMed1978

Familial myopathy. Exacerbation by hypokalemia associated with colonic polyp.

A patient with Charcot-Marie-Tooth disease developed profuse mucinous diarrhea and severe potassium depletion. After two weeks, her muscle weakness grew worse, rhabdomyolysis occurred, and kaliopenic nephropathy was suspected. The patient's diarrhea ended abruptly after a single tubular adenomatous polyp was removed from her colon. Her metabolic status became normal and remained normal six weeks after transcolonic polypectomy.

Charcot-Marie-Tooth Disease↗
PubMed1976

The demonstration of carcinoembryonic antigen in colorectal carcinoma and colonic polyps using an immunoperoxidase technique.

Carcinoembryonic antigen (CEA) has been demonstrated in tissues, by immunofluorescence, with conflicting results. Originally thought to be persent in colorectal carcinoma only, the antigen was later demonstrated in inflamed colonic mucosa and polyps. Using formalin-fixed, paraffin-embedded tissues and an immunoperoxidase technique, we have attempted to demonstrate CEA in 12 colorectal carcinomas, in adjacent benign mucosa, and in 42 polyps of varying histologic type. CEA was demonstrated in all colorectal cancers but not in adjacent inflamed mucosa. The antigen could not be demonstrated in polyps except in five cases where CEA was shown in morphologically atypical glands only. With out technique, the demonstration of CEA is a reliable indicator of malignant change in colonic mucosa. The findings in polyps tend to support the concept of carcinoma in situ in adenomatous polyps and the polyp-cancer sequence.

Adenocarcinoma↗