Types of Colon Polyps | Inflammatory, Hamartomas, Neoplastic Colon Polyps

Colon Polyp

Any circumscribed mass of tissue that arises from mucosa and protrudes into the lumen of the gastrointestinal tract is called as polyp. This is a purely clinical term and this term does not signify anything histopathologically.

Types of Polyps Colon

1. Inflammatory-
   1. Benign lymphoid polyps
   2. Pseudo-polyps (ulcerative colitis)
2. Hamartomas-
   1. Juvenile polypc
   2. Peutz-Jegher’s polyp
3. Hyperplastic polyps.
4. Neoplastic
   1. Tubular adenoma
   2. Villous adenoma
   3. Familial polyposis coli.

Inflammatory polyps

i. The benign lymphoid polyp is most frequently found in the rectum and terminal ileum.

As the name suggests, it is composed of normal lymphoid tissue, but devoid of sinuses. Benign lymphoid polyp is more common in children. Only excisional biopsy can diagnose this condition with certainty.

ii. Inflammatory polyposis is associated with ulcerative colitis or Crohn’s disease.

Hamartomas polyps

i. Juvenile polyps
As the name suggests this polyp principally occurs in children in the first decade of the life. These are uncommon after 15yrs of age and extremely rare after 30yrs.

The highest incidence is at age of 5yrs. These polyps are single in 70% of cases. Even when they are multiple, these are only 3-4 in number.

ii. Peutz-Jegher’s polyp
These polyps are situated in small intestine. They can also occur in rectum or colon and may be multiple.

Hyperplastic polyps

These are mostly of academic interest as they do not produce any symptom. These are frequently multiple. These are seen in all ages, but more frequently above 40yrs of age.

Neoplastic polyps

i. Tubular adenoma -
It is also called as adenomatous polyp and its incidence in the colon and rectum is approximately 5-10% of the general population. It is much more common than villous adenoma (8:1). It is the most common neoplasm of the colon.This condition is rare in patients under 20yrs of age. Majority of the patients are in 6^th decade.70% occur in rectum, recto-sigmoid and lower sigmoid colon within the reach of the sigmoidoscope.20% are found in the upper and middle sigmoid colon and 3% in the descending colon.

ii. Villous adenoma -
Also called as papillary adenoma. 60% of villous adenomas are over 2cm in diameter. It is much rarer than tubular adenoma. It is more common in 7^th decade and this is rarely seen below the ag

iii. Familial polyposis coli -
Carcinoma of the colon will develop in essentially 100% of patients with familial polyposis is unless treated or death from another cause supervenes. This is a rare condition. These usually start at the age of about 13yrs in the distal segments of the colon and rectum. Cancer associated with this disease is often multiple. If untreated, majority die of carcinoma before the age of 50yrs.

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