goodduck

Colonic Polyps

[classification]
1. non-neoplastic: hyperplastic, inflammatory, submucosal, mucosal polyps
2. neoplastic: adenomatous -> villous, tubular, mixed
3. hamatomatous: Peutz-Jegher syndrome, Juvenile polyps syndrome
                    
[keypoint]
1.  hyperplastic: <5mm, most in rectosigmoid, most common non-neoplastic, rare CA
2.  ademomatous:  2/3 colonic polyps are adenomatous!  tubular more numerness and more benign than villous.
3.  villous portion increase, CA increase 
4.  25~30% will present new polyps when colonscope repeat in 3 years
5.  3~5 years repeat colonscope, change according to size / number / morphology/ pathology

[risk]
1. age
2. family history
3. HNPCC/ FAP
4. diet
5. obesity
6. IBD

[malignancy criteria]
1. firm
2. friability
3. adherence
4. ulceration

[ feature v.s high-grade dysplasia (CIS) ]
1.  villous                                31%
2.  large adenoma (>1cm)  21%
3.  medium-sized  (0.6~1)     5%
4.  tubular                                  2%
5.  small-sized (<=0.5)           1%