Other gastrointestinal polyps

Abstract

Gastrointestinal polyp is a descriptive concept--observation of an elevated broad-based or stalked lesion which can be defined exactly only when examined histologically. Therefore, all polyps must, in principle, be snared or excised to achieve a final diagnosis. Nonneoplastic polyps or tumor-like lesions were formerly considered innocent findings with no malignant potential, while neoplastic adenomas with dysplasia are well-known premalignant lesions. This view of the totally harmless nature of nonneoplastic polyps is no longer true. At least the dominantly inherited juvenile polyposis and Peutz-Jeghers polyposis syndromes definitely have malignant potential through adenomatous change in the originally hamartomatous lesions. Consequently, juvenile polyposis is best treated with colectomy and ileorectal anastomosis, and repeated multiple polypectomies are now recommended in Peutz-Jeghers polyposis, in combination with laparotomy when feasible. In addition, hyperplastic gastric polyps may reflect an underlying atrophic gastritis implying increased risk of gastric carcinoid tumors and cancer. Furthermore, even colorectal hyperplastic polyps may undergo adenomatous change, and thus represent, theoretically, a reservoir from which adenomas arise.