Spectrum of Colonic Polyps in a South Indian Urban Cohort

ABSTRACT Background: The histological nature of polyps by site prevalence and size is unclear. Aim: To determine the prevalence of polyps in patients undergoing routine lower gastrointestinal (LGI) endoscopy and identify the histological types and their characteristics by age, location and size. Materials and Methods: For this retrospective study, patients undergoing ileocolonoscopy or sigmoidoscopy between 2014 and 2016 were included. Data on age, gender, test indication, site and size of polyps and histology type were collected. Results: Two hundred and ninety (12.7%) of 2303 patients who underwent LGI endoscopy had colonic polyps (n= 317; single in 272 patients). The median age was 61.1 years (range 5-99 years) and 223 (76.4%) were men. Polyps were rare <40 years age (7.3%). By site, the polyp frequency in right colon was 6.9%, 3.9% in left colon and 4.6% in the rectum. Two thirds of polyps (64%) were <1cm size. The 3 common polyp types were adenomatous (48.9%), hyperplastic (23.7%), and inflammatory (22.4%). Adenomatous polyps were common above 60 years (p <0.0002), located often in right (35.5%) or left colon (42.6%), large in size (54.2%) and showed low grade dysplasia (89.7%). Hyperplastic polyps were most common in the middle aged and in the rectum (p <0.00001). Inflammatory polyps were the most common type below 40 years age. Almost all hyperplastic and inflammatory polyps were <1cm size (93.3% and 87.3%). Conclusions: Adenomatous polyps were the commonest type; especially >60 years age. High grade dysplasia and carcinoma were rare (10.3%). While two-thirds of polyps <1cm size were inflammatory or hyperplastic, 86% of large polyps were adenomatous.

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W1993 Mixed Hyperplastic-Adenomatous Polyps Are Distinct from Sessile Serrated Adenomas with Low-Grade Dysplasia

Gastroenterology ◽

10.1016/s0016-5085(09)63551-4 ◽

2009 ◽

Vol 136 (5) ◽

pp. A-769

Author(s):

Richard H. Lash ◽

Jason Schmidt ◽

Christopher M. Schuler

Keyword(s):

Adenomatous Polyps ◽

Low Grade ◽

Low Grade Dysplasia ◽

Serrated Adenomas

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LOW-GRADE DYSPLASIA, ENDOSCOPIC PREDICTORS, MANAGEMENT TACTICS

Surgical Practice ◽

10.38181/2223-2427-2020-2-10-14 ◽

2020 ◽

pp. 10-14

Author(s):

A. A. Arkhipova ◽

V. V. Anischenko

Keyword(s):

Precancerous Lesions ◽

Low Grade ◽

Cytological Examination ◽

Spontaneous Bleeding ◽

Mild Dysplasia ◽

Brush Biopsy ◽

White Light Endoscopy ◽

Low Grade Dysplasia ◽

H Pylori ◽

Almost All

Almost all East Asian strains and 60% of Western H. pylori strains are of cagA +. The infected patients develop a more pronounced inflammation with ulceration of stomach, and also are under a higher risk of development of cancer.Objective: to improve the informative value of dysplasia diagnosis by combining white light endoscopy with chromoscopy, supplemented by target brush biopsy with cytological examination.Methods and materials: for the period from 2016 to 2018, the study included 41 patients undergoing examination and treatment of chronic gastritis. The analyzed cases included 16 (39%) men and 25 (61%) women. The age of the patients ranged from 19 to 86 years. All patients underwent esophagogastroduodenoscopy, chromoendoscopy with 0.5% methylene blue, brush biopsy (scraping with a nylon brush). At least two brush preparations were obtained: body of the stomach, antrum, scraping was also made on the surface of erosions and areas of atypical structure of the epithelium. Brush preparations were sent for cytological examination. Results: esophagogastroduodenoscopy revealed erosions in 37 (90.2%) patients, in 6 cases (14.6%) among them spontaneous bleeding was determined. In 23 (56%) patients visual signs of atrophic gastritis were noted. Cylindrical epithelium of the intestinal type was revealed in 25 patients (61%) using methylene blue.The cytological examination of the brush preparation showed proliferation of the integumentary epithelium with signs of mild dysplasia in all cases, intestinal metaplasia was revealed in 27 patients (65.8%), H. Pylori was confirmed in 38 patients (92.6%).Conclusion: chromoscopy and brush biopsy are simple and affordable methods, and their integration into routine endoscopy increases the informative value of the study, namely, allows detection of precancerous lesions of mucosa.

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Sa1594 Rate of Advanced Neoplasia After Polypectomy of Diminutive (1-5 mm) vs. Small (6-9 mm) Adenomatous Polyps With Low Grade Dysplasia

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2015.03.1383 ◽

2015 ◽

Vol 81 (5) ◽

pp. AB275

Author(s):

Orly Sneh Arbib ◽

Valentina Zemser ◽

Rachel Gingold-Belfer ◽

Alex Vilkin ◽

Yaara Leiboboici Weissman ◽

...

Keyword(s):

Adenomatous Polyps ◽

Low Grade ◽

Advanced Neoplasia ◽

Low Grade Dysplasia

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Dysplastic Progression to Adenocarcinoma is Equivalent in Ulcerative Colitis and Crohn’s Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa133 ◽

2020 ◽

Author(s):

Amy L Lightner ◽

Sarah Vogler ◽

John McMichael ◽

Xue Jia ◽

Miguel Regueiro ◽

...

Keyword(s):

Ulcerative Colitis ◽

Low Grade ◽

High Grade ◽

Surveillance Colonoscopy ◽

Right Colon ◽

Significant Difference ◽

Rate Of Progression ◽

Low Grade Dysplasia ◽

The Right ◽

Crohn’S Diseases

Abstract Background We sought to determine the rate of progression from dysplasia to adenocarcinoma in ulcerative colitis [UC] vs Crohn’s diseases [CD] and describe the risk factors unique to each. Methods All adult patients [≥18 years] with a known diagnosis of either UC or CD who underwent a surveillance colonoscopy between January 1, 2010 and January 1, 2020 were included. Results A total of 23 751 surveillance colonoscopies were performed among 12 289 patients between January 1, 2010 and January 1, 2020; 6909 [56.2%] had a diagnosis of CD and 5380 [43.8%] had a diagnosis of UC. There were a total of 668 patients [5.4%] with low-grade dysplasia [LGD], 76 patients [0.62%] with high-grade dysplasia [HGD], and 68 patients [0.55%] with adenocarcinoma in the series; the majority of the dysplastic events were located in the right colon. Significantly more UC patients had a dysplastic event, but the rate of LGD and HGD dysplasia progression to adenocarcinoma was not significantly different in CD or UC [p = 0.682 and p = 1.0, respectively]. There was no significant difference in the rate of progression from LGD/HGD to adenocarcinoma based on random biopsies vs targeted biopsies of visible lesions [p = 0.37]. However, the rate of progression from LGD vs HGD to adenocarcinoma was significantly greater for HGD [p < 0.001]. Conclusion While more UC patients were found to have neoplasia on colonoscopy, the rate of progression from LGD and HGD to adenocarcinoma was equivalent in UC and CD, suggesting that endoscopic surveillance strategies can remain consistent for all IBD patients.

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Sessile serrated adenomas: prevalence of dysplasia and carcinoma in 2139 patients

Journal of Clinical Pathology ◽

10.1136/jcp.2010.075507 ◽

2010 ◽

Vol 63 (8) ◽

pp. 681-686 ◽

Cited By ~ 189

Author(s):

Richard H Lash ◽

Robert M Genta ◽

Christopher M Schuler

Keyword(s):

Colorectal Polyps ◽

High Grade Dysplasia ◽

Progression Rate ◽

Low Grade ◽

High Grade ◽

Right Colon ◽

The Difference ◽

The Right ◽

Almost All ◽

Serrated Adenomas

Background and aimsSessile serrated adenomas (SSAs) are recognised as precursors to microsatellite unstable adenocarcinomas. This study attempts to estimate the progression rate of SSAs based upon the epidemiology of a large cohort as well as identify relationships to other colorectal polyps.MethodsPathological reports generated at Caris Diagnostics from 290 810 colonoscopic specimens on 179 111 patients were analysed using computerised algorithms.ResultsSSAs with or without dysplasia/carcinoma (SSA+/–) were identified in 2416 specimens from 2139 patients (54% women). The distribution of SSA+/– was: right-sided (81.2%); left-sided (11.2%); both right- and left-sided (3.2%); not specified (4.3%). There were 1816 (85%) patients without dysplasia (SSA–), 257 (12%) with low-grade dysplasia (SSA-LD), 45 (2%) with high-grade dysplasia (SSA-HD) and 21 (1%) with adenocarcinoma (SSA-CA). The difference in median age between almost all groups was significant (SSA–=61 years versus SSA-LD=66 years (p<0.001) vs SSA-HD=72 years (p=0.002) vs SSA-CA=76 years (p=0.07, NS)). Women comprised 53% of the SSA– group (968/1816), 57% of the SSA-LD group (147/257), 69% of the SSA-HD group (31/45) and 76% of the SSA-CA group (16/21), being more likely to have high-grade dysplasia (OR 1.94, 95% CI 1.03 to 3.67) and adenocarcinoma (OR 2.80, 95% CI 1.02 to 7.68).Conclusions1.7% of patients with mucosal polyps had SSAs (with and without dysplasia), more commonly in women and primarily in the right colon. Dysplasia or carcinoma was identified in 15% of patients and significantly disproportionately among women. Based on significant age differences between groups, there appears to be a stepwise progression of dysplasia and carcinoma in SSAs over 10 to 15 years, a period two to three times longer than that for conventional adenomas.

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