Polyps - Types of Polyps, Causes, Symptoms, Diagnosis, Care

Definition of polyp

In pathology, the term "polyp" defines an anomalous tissue spongescence, soft and spongy, which grows along a mucous membrane and protrudes into a body cavity. In the figure we see the example of intestinal polyps, which develop in the mucosa of the colon.

Classification

Polyps are classified based on several elements:

  • Shape and surface: the polyps can have a regular shape and a smooth surface, or show an evident irregularity, with a rough and knurled surface.
  • Anchoring method: the polyps can be sessile or pedunculated. In the first case, the polyps are anchored to the mucosa with all their base; otherwise, the pedunculated polyps adhere to the mucosa by means of a peduncle, a sort of cup-shaped protuberance.
  • Growth: polyps can grow singly or in pairs, or form clusters made up of many small polyps. In the latter case, the octopus takes on a particular shape, comparable to a bunch of grapes or a cauliflower. When more polyps grow in the same anatomical site, one speaks more correctly about polyposis .
  • Size: there are very small polyps - with dimensions of just a few millimeters - and giant polyps, able to exceed 2 centimeters in diameter. Large polyps, as well as agglomerates consisting of numerous tiny polyps, tend to cause problems and more pronounced discomforts than smaller ones.
  • Cytological composition (benign and malignant polyps). We speak of benign polyps (adenomas or papillomas) when the cells within them proliferate, giving rise to a more or less expansive neoformation, without causing any damage to the surrounding tissues. Otherwise, the malignant polyp (adenocarcinoma or carcinoma) is able to invade adjacent tissues and organs, triggering a series of catastrophic chain cellular events.
  • Localization: polyps can originate in several anatomical sites. The target of the polyps is constituted by the mucous membranes and, according to the cavity from which they protrude, they are distinguished:
      • Polyps of the nose and ear
      • Uterine polyps: endometrial and cervical
      • Intestinal polyps: small (rare), colon and rectum
      • Bladder polyps
      • Stomach polyps

Summary table

NASAL POLYPES
CAUSES SYMPTOMS DIAGNOSIS THERAPY
No certain cause.

Hypothesis:

  • Allergy
  • Asthma
  • Cystic fibrosis
  • Sinusitis
  • Immunodeficiency diseases
  • Smog and drugs
  • ageusia
  • Anosmia
  • Headache
  • Nasal congestion
  • Dyspnoea
  • Facial pain
  • Increased tearing
  • rhinorrhoea
  • Ocular itching
  • Snoring
  • history
  • Otorhinolaryngology visit
  • Allergy tests
  • Hematological tests
  • Nasal and olfactory respiratory function test
  • Imaging test (CT or MRI)
  • Endoscopic tests
  • Cystic fibrosis test
  • Drug therapy: corticosteroids / antihistamines / antibiotics or antifungals
  • polypectomy
  • Endoscopic sinus surgery
UTERINE POLYPS
CAUSES SYMPTOMS DIAGNOSIS THERAPY
Uncertain cause.

Hypothesis:

estrogenic changes. Women during the premenopause are the most affected

Menstrual changes:
  • dysmenorrhea
  • menorrhagia
  • hypermenorrhoea
  • menstrual irregularities
  • spotting
Dyspareunia (pain during sexual intercourse)
  • sonohysterogram
  • Diagnostic hysteroscopy
  • hysterosalpingography
  • Scratching
  • Drug therapy with progestins or gonadotropins (ineffective)
  • Surgical removal by hysteroscopy
  • Hysterectomy (removal of the uterus in the case of malignant evolution)
INTESTINAL POLYPES
CAUSES SYMPTOMS DIAGNOSIS THERAPY
  • Unbalanced diet, rich in red meat, saturated fat and low in fiber
  • Old age
  • Familiarity
  • sedentary
  • Obesity
  • Black race
  • Anemia
  • Abdominal colics
  • Abdominal cramps
  • Diarrhea / Constipation
  • Mucorrea
  • Blood in the stool
  • Rectal tenesmus
  • Colonoscopy
  • TC
  • Sigmoidoscopy
  • Stool examination
  • Opaque enema (radiological examination of the large intestine)
  • Polypectomy: surgical removal of the polyp by endoscopy
  • Burn (for small polyps)
  • Colectomy (colon removal)

+

Post-operative chemotherapy treatment to prevent recurrences (for malignant forms)

BUMPER POLYPSES
CAUSES SYMPTOMS DIAGNOSIS THERAPY
Uncertain cause

Hypothesis:

  • smoking
  • Exposure to polycyclic aromatic hydrocarbons, pollutants and smog
  • Schistosomiasis
  • Alteration of urinary frequency
  • hematuria
  • pollakiuria
  • Strangury
  • Physical examination
  • Cystoscopy
  • Biopsy
  • Washing (or irrigation) of the bladder
  • Search for any markers of bladder cancer
  • Imaging tests (CT and MRI)
  • Trans urethral resection
  • Surgical removal of the bladder (for malignant forms)

+

Post-operative chemo / radiotherapy treatment to prevent recurrences (for malignant forms)

POLYPS OF THE STOMACH
CAUSES SYMPTOMS DIAGNOSIS THERAPY
  • Chronic inflammation of the stomach (gastritis) → hyperplastic gastric polyps
  • Familial adenomatous polyposis (hereditary disease)
  • Old age
  • H. pylori infections
  • Long-term therapy with proton pump inhibitors
  • Abdominal pain
  • Abdominal tenderness to pressure
  • Gastric bleeding
  • Nausea and vomit
  • Endoscopic ultrasound (eco-biopsy)
  • Gastric biopsy
  • Blood analysis
  • No treatment (small gastric polyps can regress spontaneously)
  • Surgical removal (for large polyps)
  • Antibiotic treatment (triple therapy) for the treatment of polyps dependent on Helicobacter pylori

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