Hyperplastic polyps

Hyperplastic Polyps are a type of polyp found in the colon and rectum. They are considered one of the most common types of colorectal polyps and are generally regarded as benign, with a very low risk of transforming into cancer. Hyperplastic polyps are part of a broader category of polyps known as non-neoplastic polyps, which also includes inflammatory polyps and hamartomatous polyps.

Characteristics

Hyperplastic polyps are typically small, measuring less than 5 mm in diameter, and are often found in the rectosigmoid region of the colon. Histologically, they are characterized by the proliferation of glandular epithelium with a sawtooth or serrated appearance. Despite their benign nature, the presence of hyperplastic polyps, especially those with a serrated pathway, has been associated with an increased risk of developing serrated syndrome and colorectal cancer, particularly when they are larger in size or located in the proximal colon.

Diagnosis

The diagnosis of hyperplastic polyps is usually made during a colonoscopy, where they can be visually identified and removed for further histological examination. The appearance of hyperplastic polyps under a microscope, showing elongated crypts with a serrated pattern, is key to their identification. It is important for pathologists to distinguish between hyperplastic polyps and other types of serrated polyps, such as sessile serrated adenomas (SSAs) or traditional serrated adenomas (TSAs), due to their different malignant potentials.

Management

The management of hyperplastic polyps typically involves their removal during colonoscopy. Given their low risk of malignancy, no additional treatment is usually required for hyperplastic polyps themselves. However, the discovery of hyperplastic polyps may influence the interval at which future colonoscopies are recommended, especially if they are part of a pattern indicating a higher risk of colorectal cancer.

Prevention and Screening

Regular screening through colonoscopy is crucial for the early detection and removal of precancerous polyps, including hyperplastic polyps, to prevent colorectal cancer. The American Cancer Society recommends that individuals at average risk of colorectal cancer begin regular screenings at age 45. Those with a family history of colorectal cancer or polyps may need to start screening earlier and may require more frequent screenings.

Conclusion

While hyperplastic polyps are generally considered benign and carry a low risk of progressing to cancer, their presence, especially in certain conditions, can indicate an increased risk of colorectal cancer. Therefore, their identification and removal during colonoscopy are important components of colorectal cancer prevention strategies.

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