Adenoma

Colonic adenomas

Updated: 03/02/2021

© Jun Wang, MD, PhD

General features
  • Most common neoplastic polyps
  • Premalignant lesion
  • Common in population older than 50
  • Pedunculated (with stalk), sessile or flat
  • Associated with cigarette smoking, high BMI and red meat diet
  • Majority may be classified based on proportion of villous components as tubular (<25%), tubulovillous (25-75%), or villous (>75%)
  • May have mixed components: sessile serrated adenoma
Clinical presentations
  • Usually asymptomatic
  • Villous adenoma has higher risk of malignancy
Key morphological features
Genetic abnormalities
  • Various
  • Activation of KRAS
  • Wnt pathway: APC, beta-catenin
Treatment
  • Polypectomy
  • Mucosal resection or partial colectomy if high grade dysplasia present or large polyp


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