Colon, rectum and anus
Michael Gaunt, Tjun Tang, Stewart Walsh in General Surgery Outpatient Decisions, 2018
A polyp is an abnormal overgrowth of the colonic mucosa and can be sessile (flat) or pedunculated (on a stalk). Polyps fall into the following categories. Inflammatory: occur in UC, Crohn’s, diverticulitis, chronic dysentery and, rarely, benign lymphoid hyperplasia.Hamartomatous polyps: juvenile and Peutz-Jeghers (P-J) have significant malignant potential.Metaplastic polyps: size 1–2mm, rarely larger than 5mm; biopsy confirms the diagnosis and they need no ongoing observation.Adenomatous polyps: benign tumours composed of abnormal colonic glands. Classified according to the growth pattern of the glands: 75% are tubular adenomas, 10% villous and 15% tubulovillous adenomas. All have malignant potential.
Structural Disorders of the Vocal Cords
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
In many cases the exact cause of polyp formation is not known, but most authors agree that phonotrauma is an important aetiological factor. Some are heralded by a sudden onset of hoarseness or loss of voice after yelling or shouting, particularly if the vocal folds are inflamed from acute infective laryngitis or extraoesophageal reflux. A large proportion of patients with vocal cord polyps are also smokers. Cigarette smoking can cause injury to the vocal cord leading to hyaline degeneration in polyps.35 There appears to be disruption to the vascular basement membrane, capillary proliferation, thrombosis, minute haemorrhage and fibrin exudation.36 Although some polyps have a haemorrhagic appearance, others are more gelatinous and grey. Whether these gelatinous polyps have a different pathogenesis is not known.34, 37 Occasionally, a sulcus, mucosal bridge or intracordal cyst is found immediately opposite on the other vocal fold.38, 39 It is hypothesized that in these cases the resulting disordered vibration and stiffness of the vocal fold make it more likely to damage the other vocal cord causing localized trauma and polyp formation.
Colonic Bleeding
John F. Pohl, Christopher Jolley, Daniel Gelfond in Pediatric Gastroenterology, 2014
Polyps are covered in greater detail in Chapter 45. Briefly, colonic polyps have been found in approximately 6% of children undergoing colonoscopy for any indication and 12% for those with lower GI bleeding. Solitary juvenile polyps do not carry increased risk for malignant transformation. The hamartomatous polyposis syndromes, such as juvenile polyposis syndrome, Peutz–Jeghers syndrome, and Cowden syndrome, involve multiple polyps with genetic mutations underlying their development and carry an increased risk of malignancy. Adenomatous polyps are present in familial adenomatous polyposis which carries 100% risk of malignancy by the fifth decade of life (54.9). Children with colonic polyps are typically well appearing, with a complaint of painless rectal bleeding. Other symptoms may include abdominal pain or rectal prolapse of the polyp. Bleeding occurs from the friability of the polyp mucosa or from the base after the polyp outgrows its blood supply and auto-amputates (54.10). Colonoscopy should be performed if a polyp is suspected for diagnostic and therapeutic purposes. Flexible sigmoidoscopy is inadequate as a significant minority of polyps will be in the right colon. A solitary juvenile polyp carries an excellent prognosis, as polypectomy is often curative. The prognosis is variable for the polyposis syndromes, as each carries its own malignant transformation risk over time and the need for serial colonoscopic evaluations.
Some Bryophytes Trigger Cytotoxicity of Stem Cell-like Population in 5-Fluorouracil Resistant Colon Cancer Cells
Published in Nutrition and Cancer, 2022
Dilşad Özerkan, Ayşe Erol, Ergin Murat Altuner, Kerem Canlı, Dürdane Serap Kuruca
Colorectal cancer usually develops in 3-5 years. They develop from benign tumors called polyps in the intestine at a rate of 60% or some inflammatory colon diseases such as Crohn’s disease or ulcerative colitis (1). Polyps occur in the form of growth or deposition of abnormal cells that protrude from the intestinal mucosa to its lumen. The size of the polyp increases with the proliferation of the cells in it. Genetic mutations, and epigenetic changes begin to occur which indicating that there is a cytological and histological dysplasia. The degree of dysplasia increases, causing invasive carcinoma to progress with the increase in cellular DNA damage over time. If polyps do not disappear, they can invade nearby tissues and grow on the walls of the colon, and rectum. The malignant growth presenting in such way results with angiogenesis and causes cancer to spread to distant organs (2). The most important cause of death is metastasis. In stage I, many colorectal cancer patients recover with the removal of the tumor, the disease relapses again in 40% of patients in stage II, and stage III (3–5).
Colorectal cancer management: strategies in drug delivery
Published in Expert Opinion on Drug Delivery, 2022
Prabha Singh, Pramita Waghambare, Tabassum Asif Khan, Abdelwahab Omri
CRC begins with projection of a tissue called ‘polyp’ that can be cancerous or noncancerous [5]. In general, there are two main types of polyps—adenomatous polyp (adenomas) and hyperplastic polyps. Adenomatous polyps are precancerous and can change into cancer, whereas hyperplastic polyps are the most common type of polyp and are generally not precancerous [6]. In stage 0 of CRC, the tumor growth starts from the inner lining of mucosa and patients are diagnosed easily. In stage I, CRC has spread to the upper layer, i.e. sub mucosa and surgery is the best option. In stage II, CRC spreads to the third layer, i.e. muscular layer and sometimes to lymph node and beyond colon. Resection surgery is the best option to treat this stage. In stage III, CRC spreads to the serosa and lymph nodes and surgery is used to eradicate the section of the colon together with nearby lymph nodes, followed by adjuvant chemotherapy. In stage IV (advanced stage), the cancer spreads to other vital organs like liver and lungs [7]. Figure 3 depicts the different stages of CRC.
Effectiveness of different methods for polypectomy in the menopause: a retrospective study
Published in Climacteric, 2020
S. Molnár, Z. Farkas, A. Jakab, R. Lampé, P. Török
The endometrial polyp is a common lesion in both women’s reproductive and postmenopausal ages; it is a localized tumor in the uterine cavity, which represents focal hyperplasia of the basal layer of the endometrium1. Histologically, the endometrial polyp is composed of endometrial glands and stroma around a vascular axis of spiral arteries. The pathogenesis of polyps is not exactly clear; according to Baiocchi et al., it is similar to that of endometrial hyperplasia2. There are changes in the hormonal responsiveness of endometrial tissue with the increase of estrogen receptors and the decrease or disappearance of progesterone receptors, leading to unopposed estrogen stimulation3. Similarly, hormonal disorders such as chronic anovulation, luteal insufficiency, or hyperestrogenic states may cause the formation of endometrial polyps2,4. Polyps may be single or multiple, of various sizes, sessile, or pedunculated1.