Histologically, polyps may be tubular, villous, or tubulovillous. Villous adenomas are 3 times more likely to become malignant than tubular polyps. The likelihood that a polyp contains invasive cancer increases with the size of the polyp. Most polyps remain asymptomatic and are detected during routine screening colonoscopy. Less than 5% of polyps lead to bleeding.
Once an adenomatous polyp has been detected, the entire colon should undergo surveillance for polyp detection. Colonoscopy should be repeated based on the number and histology of previously discovered polyps. Family history and certain disease processes (eg, ulcerative colitis, familial adenomatous polyposis) can impact surveillance colonoscopy recommendations as well.
K63.5 – Polyp of colon
68496003 – Polyp of colon
Differential Diagnosis & Pitfalls
- Peutz-Jeghers syndrome – Intestinal hamartomatous polyps associated with mucocutaneous pigmentation.
- Familial adenomatous polyposis – Inherited as autosomal dominant disorder. Polyps are carcinogenic if left untreated.
- Gardner syndrome – Associated with osteoma in addition to colonic polyposis.
- Turcot syndrome
- Juvenile polyposis syndrome
- Hereditary nonpolyposis colon cancer
- Clostridioides difficile infection with pseudopolyposis