Colon polyp
| Classification according to ICD-10 | |
|---|---|
| K63.5 | Colon polyp |
| ICD-10 online (WHO version 2019) | |
Colon polyps are fungal growths in the lining of the large intestine . The size of the polyps varies from a few millimeters to a few centimeters. Initially, the polyps are benign and do not cause any discomfort. The larger polyps in particular can degenerate into malignant tumors ( colon cancer ).
Neoplastic polyps
In the case of neoplastic polyps, a distinction is made between non-epithelial and epithelial forms.
- Non-epithelial forms : accumulations of tissue under the mucous membrane, usually with a bulging of the mucous membrane into the interior of the intestine . Possible non-epithelial forms are e.g. B. lipomas , fibromas , hemangiomas or lymphoid polyps.
- Epithelial forms : These are mostly adenomas . They are the most common (80% of polyps). About 30% of adults over the age of 50 suffer from it. Invasive carcinoma tissue can be detected in approximately 3% of adenomas . The adenomas are divided into:
- Tubular adenomas
- Villous adenomas
- Tubulo-villous adenomas
- Serrated adenomas
More than half of the adenomas occur more than once (usually the tubular adenomas). The villous adenomas have the highest risk of degeneration .
If more than 50-100 polyps are present in a patient, one speaks of a polyposis .
Non-neoplastic polyps
- Inflammatory polyps : The specialist speaks of so-called pseudopolyps . B. occur in chronic inflammatory bowel disease.
- Hamartomas : Hamartomas are tumor-like malformations of embryonic tissue. You come z. B. in juvenile polyposis and Peutz-Jeghers syndrome .
Other polyps
- Hyperplastic polyps : A thickening of the mucous membrane caused by the local accumulation of tissue components. They show no degeneracy tendencies and are always smaller than 5 mm.
Occurrence
Tubular adenomas are the most common (75–80%). They are stalked or broad-based. Their predilection site is the recto sigmoid . If the diameter is less than one centimeter, the probability of degeneration is less than one percent, and if the diameter is over two centimeters, the probability is over ten percent. The villous adenoma is found mainly in the rectum . The probability of degeneration is well over 30 percent. The tubulovillous adenoma is a hybrid of the first two.
Colon polyps can in principle also arise from other layers of the colon. Thus, every structure that rises above the level of the mucous membrane is called a polyp. Polyps can also consist of smooth muscles ( leiomyomas ) or of fatty tissue ( lipomas ). It can also be hamartomas , hyperplastic polyps, juvenile polyps, inflammatory polyps, or pseudopolyps .
diagnosis
The diagnosis is made endoscopically , polyps are removed endoscopically in the same session and examined histologically . In the case of polyps that cannot be removed endoscopically or if they are possibly malignant, a resection in the area of the colon (colon) is performed.
Individual evidence
- ↑ Herbert Renz-Polster et al. (Ed.): Basic textbook internal medicine. 3. Edition. Urban & Fischer, Munich 2004, ISBN 3-437-41052-0 , p. 589.
See also
Familial adenomatous polyposis , Peutz-Jeghers syndrome , Turcot syndrome , adenoma-carcinoma sequence
