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id="toc-Familial_adenomatous_polyposis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hereditary_nonpolyposis_colorectal_cancer_(Lynch_Syndrome)" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hereditary_nonpolyposis_colorectal_cancer_(Lynch_Syndrome)"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Hereditary nonpolyposis colorectal cancer (Lynch Syndrome)</span> </div> </a> <ul id="toc-Hereditary_nonpolyposis_colorectal_cancer_(Lynch_Syndrome)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Peutz–Jeghers_syndrome" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Peutz–Jeghers_syndrome"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Peutz–Jeghers syndrome</span> </div> </a> <ul id="toc-Peutz–Jeghers_syndrome-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Juvenile_polyposis_syndrome" class="vector-toc-list-item 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<span class="vector-toc-numb">4.1</span> <span>Comparison table</span> </div> </a> <ul id="toc-Comparison_table-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hyperplastic_polyp" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hyperplastic_polyp"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Hyperplastic polyp</span> </div> </a> <ul id="toc-Hyperplastic_polyp-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Neoplastic_polyp" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Neoplastic_polyp"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Neoplastic polyp</span> </div> </a> <ul id="toc-Neoplastic_polyp-sublist" class="vector-toc-list"> <li id="toc-Adenomas" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Adenomas"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3.1</span> <span>Adenomas</span> </div> </a> <ul id="toc-Adenomas-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Hamartomatous_polyp" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hamartomatous_polyp"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.4</span> <span>Hamartomatous polyp</span> </div> </a> <ul id="toc-Hamartomatous_polyp-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Inflammatory_polyp" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Inflammatory_polyp"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.5</span> <span>Inflammatory polyp</span> </div> </a> <ul id="toc-Inflammatory_polyp-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Diagnosis</span> </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Diagnosis subsection</span> </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Gallery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gallery"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Gallery</span> </div> </a> <ul id="toc-Gallery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-NICE_classification" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#NICE_classification"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>NICE classification</span> </div> </a> <ul id="toc-NICE_classification-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Follow-up" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Follow-up"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Follow-up</span> </div> </a> <ul id="toc-Follow-up-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input 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<input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 17 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-17" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">17 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Dermpoliep" title="Dermpoliep – Afrikaans" lang="af" hreflang="af" data-title="Dermpoliep" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B3%D9%84%D9%8A%D9%84%D8%A9_%D9%82%D9%88%D9%84%D9%88%D9%86%D9%8A%D8%A9_%D9%85%D8%B3%D8%AA%D9%82%D9%8A%D9%85%D9%8A%D8%A9" title="سليلة قولونية مستقيمية – Arabic" lang="ar" hreflang="ar" data-title="سليلة قولونية مستقيمية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/D%C3%BCz_ba%C4%9F%C4%B1rsaq_polipl%C9%99ri" title="Düz bağırsaq polipləri – Azerbaijani" lang="az" hreflang="az" data-title="Düz bağırsaq polipləri" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/P%C3%B2lip_colorectal" title="Pòlip colorectal – Catalan" lang="ca" hreflang="ca" data-title="Pòlip colorectal" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Dickdarmpolyp" title="Dickdarmpolyp – German" lang="de" hreflang="de" data-title="Dickdarmpolyp" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/P%C3%B3lipos_de_colon_y_recto" title="Pólipos de colon y recto – Spanish" lang="es" hreflang="es" data-title="Pólipos de colon y recto" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Polype_colorectal" title="Polype colorectal – French" lang="fr" hreflang="fr" data-title="Polype colorectal" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%8C%80%EC%9E%A5%EC%9A%A9%EC%A2%85" title="대장용종 – Korean" lang="ko" hreflang="ko" data-title="대장용종" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%BF%D5%B8%D5%AC%D5%B8%D5%BC%D5%A5%D5%AF%D5%BF%D5%A1%D5%AC_%D5%BA%D5%B8%D5%AC%D5%AB%D5%BA" title="Կոլոռեկտալ պոլիպ – Armenian" lang="hy" hreflang="hy" data-title="Կոլոռեկտալ պոլիպ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Darmpoliep" title="Darmpoliep – Dutch" lang="nl" hreflang="nl" data-title="Darmpoliep" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B2%E0%A5%8B%E0%A4%B0%E0%A5%87%E0%A4%95%E0%A5%8D%E0%A4%9F%E0%A4%B2_%E0%A4%AA%E0%A5%8B%E0%A4%B2%E0%A4%BF%E0%A4%AA" title="कोलोरेक्टल पोलिप – Nepali" lang="ne" hreflang="ne" data-title="कोलोरेक्टल पोलिप" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target"><span>नेपाली</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%A4%A7%E8%85%B8%E3%83%9D%E3%83%AA%E3%83%BC%E3%83%97" title="大腸ポリープ – Japanese" lang="ja" hreflang="ja" data-title="大腸ポリープ" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%95%E0%AD%8B%E0%AC%B2%E0%AD%8B%E0%AC%B0%E0%AD%87%E0%AC%95%E0%AD%8D%E0%AC%9F%E0%AC%BE%E0%AC%B2%E0%AD%8D_%E0%AC%AA%E0%AC%B2%E0%AC%BF%E0%AC%AA%E0%AD%8D" title="କୋଲୋରେକ୍ଟାଲ୍ ପଲିପ୍ – Odia" lang="or" hreflang="or" data-title="କୋଲୋରେକ୍ଟାଲ୍ ପଲିପ୍" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/P%C3%B3lipo_intestinal" title="Pólipo intestinal – Portuguese" lang="pt" hreflang="pt" data-title="Pólipo intestinal" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9F%D0%BE%D0%BB%D0%B8%D0%BF_%D1%82%D0%BE%D0%BB%D1%81%D1%82%D0%BE%D0%B9_%D0%BA%D0%B8%D1%88%D0%BA%D0%B8" title="Полип толстой кишки – Russian" lang="ru" hreflang="ru" data-title="Полип толстой кишки" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Polyp_%C4%91%E1%BA%A1i_tr%E1%BB%B1c_tr%C3%A0ng" title="Polyp đại trực tràng – Vietnamese" lang="vi" hreflang="vi" data-title="Polyp đại trực tràng" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E5%A4%A7%E8%82%A0%E6%81%AF%E8%82%89" title="大肠息肉 – Chinese" lang="zh" hreflang="zh" data-title="大肠息肉" data-language-autonym="中文" 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id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Growth found in bowel wall</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Colon polyps</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Polyp-2.jpeg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Polyp-2.jpeg/220px-Polyp-2.jpeg" decoding="async" width="220" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Polyp-2.jpeg/330px-Polyp-2.jpeg 1.5x, //upload.wikimedia.org/wikipedia/commons/b/b8/Polyp-2.jpeg 2x" data-file-width="332" data-file-height="332" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Polyp of sigmoid colon as revealed by colonoscopy. Approximately 1 cm in diameter. The polyp was removed by <a href="/wiki/Snare_cautery" class="mw-redirect" title="Snare cautery">snare cautery</a>.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a> <span class="penicon autoconfirmed-show"><span class="mw-valign-text-top" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q1209892?uselang=en#P1995" title="Edit this on Wikidata"><img alt="Edit this on Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></td></tr></tbody></table> <p>A <b>colorectal polyp</b> is a <a href="/wiki/Polyp_(medicine)" title="Polyp (medicine)">polyp</a> (fleshy growth) occurring on the lining of the <a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">colon</a> or <a href="/wiki/Rectum" title="Rectum">rectum</a>.<sup id="cite_ref-MedNet_1-0" class="reference"><a href="#cite_note-MedNet-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Untreated colorectal polyps can develop into <a href="/wiki/Colorectal_cancer" title="Colorectal cancer">colorectal cancer</a>.<sup id="cite_ref-Medline_2-0" class="reference"><a href="#cite_note-Medline-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Colorectal polyps are often classified by their behaviour (i.e. benign vs. malignant) or cause (e.g. as a consequence of <a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">inflammatory bowel disease</a>). They may be benign (e.g. hyperplastic polyp), pre-malignant (e.g. <a href="/wiki/Tubular_adenoma" class="mw-redirect" title="Tubular adenoma">tubular adenoma</a>) or malignant (e.g. colorectal adenocarcinoma). </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Colorectal polyps are not usually associated with symptoms.<sup id="cite_ref-Medline_2-1" class="reference"><a href="#cite_note-Medline-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> When they occur, symptoms include <a href="/wiki/Blood_in_stool" title="Blood in stool">bloody stools</a>; changes in frequency or consistency of stools (such as a week or more of <a href="/wiki/Constipation" title="Constipation">constipation</a> or <a href="/wiki/Diarrhea" title="Diarrhea">diarrhoea</a>);<sup id="cite_ref-mayo_3-0" class="reference"><a href="#cite_note-mayo-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Fatigue" title="Fatigue">fatigue</a> arising from blood loss.<sup id="cite_ref-Medline_2-2" class="reference"><a href="#cite_note-Medline-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Anemia" title="Anemia">Anemia</a> arising from <a href="/wiki/Iron_deficiency" title="Iron deficiency">iron deficiency</a> can also present due to chronic blood loss, even in the absence of bloody stools.<sup id="cite_ref-mayo_3-1" class="reference"><a href="#cite_note-mayo-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_4-0" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Another symptom may be an increased mucus production especially those involving villous adenomas.<sup id="cite_ref-:0_4-1" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Copious production of mucus causes loss of potassium that can occasionally result in symptomatic hypokalemia.<sup id="cite_ref-:0_4-2" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Occasionally, if a polyp is big enough to cause a <a href="/wiki/Bowel_obstruction" title="Bowel obstruction">bowel obstruction</a>, there may be <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a> and severe constipation.<sup id="cite_ref-mayo_3-2" class="reference"><a href="#cite_note-mayo-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Structure">Structure</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=2" title="Edit section: Structure"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Polyps are either pedunculated (attached to the intestinal wall by a stalk) or sessile (grow directly from the wall).<sup id="cite_ref-MC_5-0" class="reference"><a href="#cite_note-MC-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:2_6-0" class="reference"><a href="#cite_note-:2-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup class="reference nowrap"><span title="Page / location: 1342">: 1342 </span></sup> In addition to the gross appearance categorization, they are further divided by their histologic appearance as tubular adenoma which are tubular glands, villous adenoma which are long finger like projections on the surface, and tubulovillous adenoma which has features of both.<sup id="cite_ref-:2_6-1" class="reference"><a href="#cite_note-:2-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup class="reference nowrap"><span title="Page / location: 1342">: 1342 </span></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Genetics">Genetics</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=3" title="Edit section: Genetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Hereditary syndromes causing increased colorectal polyp formation include: </p> <ul><li><a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">Familial adenomatous polyposis</a> (FAP)<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hereditary_nonpolyposis_colorectal_cancer" title="Hereditary nonpolyposis colorectal cancer">Hereditary nonpolyposis colorectal cancer</a></li> <li><a href="/wiki/Peutz%E2%80%93Jeghers_syndrome" title="Peutz–Jeghers syndrome">Peutz–Jeghers syndrome</a></li> <li><a href="/wiki/Juvenile_polyposis_syndrome" title="Juvenile polyposis syndrome">Juvenile polyposis syndrome</a></li></ul> <p>Several genes have been associated with polyposis, such as <a href="/wiki/GREM1" class="mw-redirect" title="GREM1">GREM1</a>, <a href="/wiki/MSH3" title="MSH3">MSH3</a>, <a href="/wiki/MLH3" title="MLH3">MLH3</a>, <a href="/wiki/NTHL1" title="NTHL1">NTHL1</a>, <a href="/wiki/RNF43" title="RNF43">RNF43</a> and <a href="/wiki/RPS20" class="mw-redirect" title="RPS20">RPS20</a>.<sup id="cite_ref-Valle2019_8-0" class="reference"><a href="#cite_note-Valle2019-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Familial_adenomatous_polyposis">Familial adenomatous polyposis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=4" title="Edit section: Familial adenomatous polyposis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">Familial adenomatous polyposis</a></div> <p><i><a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">Familial adenomatous polyposis</a></i> (FAP) is a form of hereditary cancer syndrome involving the APC gene located on chromosome q521.<sup id="cite_ref-:1_9-0" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The syndrome was first described in 1863 by Virchow on a 15-year-old boy with multiple polyps in his colon.<sup id="cite_ref-:1_9-1" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The syndrome involves development of multiple polyps at an early age and those left untreated will all eventually develop cancer.<sup id="cite_ref-:1_9-2" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The gene is expressed 100% in those with the mutation and it is autosomal dominant.<sup id="cite_ref-:1_9-3" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> 10–20% of patients have negative family history and acquire the syndrome from spontaneous <a href="/wiki/Germline_mutation" title="Germline mutation">germline mutation</a>.<sup id="cite_ref-:1_9-4" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The average age of newly diagnosed patient is 29 and the average age of newly discovered colorectal cancer is 39.<sup id="cite_ref-:1_9-5" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It is recommended that those affected undergo colorectal cancer screening at younger age with treatment and prevention are surgical with removal of affected tissues.<sup id="cite_ref-:1_9-6" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Hereditary_nonpolyposis_colorectal_cancer_(Lynch_Syndrome)"><span id="Hereditary_nonpolyposis_colorectal_cancer_.28Lynch_Syndrome.29"></span>Hereditary nonpolyposis colorectal cancer (Lynch Syndrome)</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=5" title="Edit section: Hereditary nonpolyposis colorectal cancer (Lynch Syndrome)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Hereditary_nonpolyposis_colorectal_cancer" title="Hereditary nonpolyposis colorectal cancer">Hereditary nonpolyposis colorectal cancer</a></div> <p><i><a href="/wiki/Hereditary_nonpolyposis_colorectal_cancer" title="Hereditary nonpolyposis colorectal cancer">Hereditary nonpolyposis colorectal cancer</a> (HNPCC, also known as Lynch syndrome)</i> is a hereditary colorectal cancer syndrome.<sup id="cite_ref-:1_9-7" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It is the most common hereditary form of colorectal cancer in the United States and accounts for about 3% of all cases of cancer.<sup id="cite_ref-:1_9-8" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It was first recognized by Alder S. Warthin in 1885 at the University of Michigan.<sup id="cite_ref-:1_9-9" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It was later further studied by Henry Lynch who recognized an autosomal dominant transmission pattern with those affected having relatively early onset of cancer (mean age 44 years), greater occurrence of proximal lesions, mostly mucinous or poorly differentiated adenocarcinoma, greater number of synchronous and metachronous cancer cells, and good outcome after surgical intervention.<sup id="cite_ref-:1_9-10" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The Amsterdam Criteria were initially used to define Lynch syndrome before the underlying genetic mechanism had been worked out.<sup id="cite_ref-:1_9-11" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The Criteria required that the patient has three family members all first-degree relatives with colorectal cancer that involves at least two generations with at least one affected person being younger than 50 years of age when the diagnosis was made.<sup id="cite_ref-:1_9-12" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The Amsterdam Criteria is too restrictive and was later expanded to include cancers of endometrial, ovarian, gastric, pancreatic, small intestinal, ureteral, and renal pelvic origin.<sup id="cite_ref-:1_9-13" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The increased risk of cancer seen in patients with by the syndrome is associated with dysfunction of DNA repair mechanism.<sup id="cite_ref-:1_9-14" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Molecular biologists have linked the syndrome to specific genes such as hMSH2, hMSH1, hMSH6, and hPMS2.<sup id="cite_ref-:1_9-15" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Peutz–Jeghers_syndrome"><span id="Peutz.E2.80.93Jeghers_syndrome"></span>Peutz–Jeghers syndrome</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=6" title="Edit section: Peutz–Jeghers syndrome"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Peutz%E2%80%93Jeghers_syndrome" title="Peutz–Jeghers syndrome">Peutz–Jeghers syndrome</a></div> <p><i><a href="/wiki/Peutz%E2%80%93Jeghers_syndrome" title="Peutz–Jeghers syndrome">Peutz–Jeghers syndrome</a></i> is an autosomal dominant syndrome that presents with hamartomatous polyps, which are disorganized growth of tissues of the intestinal tract, and hyperpigmentation of the interlining of the mouth, lips and fingers.<sup id="cite_ref-:1_9-16" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The syndrome was first noted in 1896 by Hutchinson, and later separately described by Peutz, and then again in 1940 by Jeghers.<sup id="cite_ref-:1_9-17" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The syndrome is associated with malfunction of serine-threonine kinase 11 or STK 11 gene, and has a 2–10% increase in risk of developing cancer of the intestinal tract.<sup id="cite_ref-:1_9-18" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The syndrome also causes increased risk of extraintestinal cancer such as that involving breast, ovary, cervix, fallopian tubes, thyroid, lung, gallbladder, bile ducts, pancreas, and testicles.<sup id="cite_ref-:1_9-19" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The polyps often bleeds and may cause obstruction that would require surgery.<sup id="cite_ref-:1_9-20" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Any polyps larger than 1.5 cm needs removal and patients should be monitored closely and screen every two years for malignancy.<sup id="cite_ref-:1_9-21" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Juvenile_polyposis_syndrome">Juvenile polyposis syndrome</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=7" title="Edit section: Juvenile polyposis syndrome"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Juvenile_polyposis_syndrome" title="Juvenile polyposis syndrome">Juvenile polyposis syndrome</a></div> <p><i><a href="/wiki/Juvenile_polyposis_syndrome" title="Juvenile polyposis syndrome">Juvenile polyposis syndrome</a></i> is an autosomal dominant syndrome characterized by increased risk of cancer of intestinal tract and extraintestinal cancer.<sup id="cite_ref-:1_9-22" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It often presents with bleeding and obstruction of the intestinal tract along with low serum albumin due to protein loss in the intestine.<sup id="cite_ref-:1_9-23" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The syndrome is linked to malfunction of SMAD4 a tumor suppression gene that is seen in 50% of cases.<sup id="cite_ref-:1_9-24" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Individuals with multiple juvenile polyps have at least 10% chance of developing malignancy and should undergo abdominal colectomy with ileorectal anastomosis, and close monitoring via endoscopy of rectum.<sup id="cite_ref-:1_9-25" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> For individuals with few juvenile polyps, patients should undergo endoscopic polypectomy.<sup id="cite_ref-:1_9-26" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Types">Types</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=8" title="Edit section: Types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Pie_chart_of_colorectal_polyp_etiologies.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3a/Pie_chart_of_colorectal_polyp_etiologies.png/250px-Pie_chart_of_colorectal_polyp_etiologies.png" decoding="async" width="250" height="171" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3a/Pie_chart_of_colorectal_polyp_etiologies.png/375px-Pie_chart_of_colorectal_polyp_etiologies.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3a/Pie_chart_of_colorectal_polyp_etiologies.png/500px-Pie_chart_of_colorectal_polyp_etiologies.png 2x" data-file-width="2417" data-file-height="1651" /></a><figcaption>Incidences and malignancy risks of various types of colorectal polyps</figcaption></figure> <p>Colorectal polyps can broadly be classified as follows: </p> <ul><li>hyperplastic,</li> <li>neoplastic (adenomatous and malignant),</li> <li>hamartomatous and,</li> <li>inflammatory.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Comparison_table">Comparison table</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=9" title="Edit section: Comparison table"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <table class="wikitable"> <caption>Colorectal polyps </caption> <tbody><tr> <th>Type</th> <th>Risk of containing malignant cells</th> <th colspan="2">Histopathology</th> <th>Image </th></tr> <tr> <th><a href="/wiki/Hyperplastic_polyp" title="Hyperplastic polyp">Hyperplastic polyp</a> </th> <td>0% </td> <td colspan="2">No dysplasia.<sup id="cite_ref-UpToDate_10-0" class="reference"><a href="#cite_note-UpToDate-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> <ul><li>Mucin-rich type: Serrated ("saw tooth") appearance, containing glands with star-shaped lumina.<sup id="cite_ref-Stanford_11-0" class="reference"><a href="#cite_note-Stanford-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Crypts that are elongated but straight, narrow and hyperchromatic at the base. All crypts reach to the muscularis mucosae.<sup id="cite_ref-Stanford_11-1" class="reference"><a href="#cite_note-Stanford-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup></li> <li>Goblet cell-rich type: Elongated, fat crypts and little to no serration. Filled with goblet cells, extending to surface, which commonly has a tufted appearance.<sup id="cite_ref-Stanford_11-2" class="reference"><a href="#cite_note-Stanford-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup></li></ul> </td> <td><span typeof="mw:File"><a href="/wiki/File:Hyperplastic_Polyp_of_the_Rectum_(14060044206).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/40/Hyperplastic_Polyp_of_the_Rectum_%2814060044206%29.jpg/180px-Hyperplastic_Polyp_of_the_Rectum_%2814060044206%29.jpg" decoding="async" width="180" height="135" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/40/Hyperplastic_Polyp_of_the_Rectum_%2814060044206%29.jpg/270px-Hyperplastic_Polyp_of_the_Rectum_%2814060044206%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/40/Hyperplastic_Polyp_of_the_Rectum_%2814060044206%29.jpg/360px-Hyperplastic_Polyp_of_the_Rectum_%2814060044206%29.jpg 2x" data-file-width="2048" data-file-height="1536" /></a></span> </td></tr> <tr> <th><a href="/wiki/Tubular_adenoma" class="mw-redirect" title="Tubular adenoma">Tubular adenoma</a> </th> <td><b>2%</b> at 1.5 cm<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </td> <td rowspan="3">Low to high grade dysplasia<sup id="cite_ref-stanford-criteria_13-0" class="reference"><a href="#cite_note-stanford-criteria-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </td> <td>Over 75% of volume has tubular appearance.<sup id="cite_ref-WHO_14-0" class="reference"><a href="#cite_note-WHO-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </td> <td><span typeof="mw:File"><a href="/wiki/File:Tubular_adenoma_of_the_colon.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/77/Tubular_adenoma_of_the_colon.jpg/180px-Tubular_adenoma_of_the_colon.jpg" decoding="async" width="180" height="109" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/77/Tubular_adenoma_of_the_colon.jpg/270px-Tubular_adenoma_of_the_colon.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/77/Tubular_adenoma_of_the_colon.jpg/360px-Tubular_adenoma_of_the_colon.jpg 2x" data-file-width="1725" data-file-height="1047" /></a></span> </td></tr> <tr> <th><a href="/wiki/Tubulovillous_adenoma" class="mw-redirect" title="Tubulovillous adenoma">Tubulovillous adenoma</a> </th> <td><b>20%</b> to <b>25%</b><sup id="cite_ref-AmersiAgustin2005_15-0" class="reference"><a href="#cite_note-AmersiAgustin2005-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </td> <td>25–75% villous<sup id="cite_ref-WHO_14-1" class="reference"><a href="#cite_note-WHO-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </td> <td><span typeof="mw:File"><a href="/wiki/File:Micrograph_of_tubulovillous_adenoma.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Micrograph_of_tubulovillous_adenoma.jpg/180px-Micrograph_of_tubulovillous_adenoma.jpg" decoding="async" width="180" height="104" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Micrograph_of_tubulovillous_adenoma.jpg/270px-Micrograph_of_tubulovillous_adenoma.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/8/8f/Micrograph_of_tubulovillous_adenoma.jpg 2x" data-file-width="316" data-file-height="183" /></a></span> </td></tr> <tr> <th><a href="/wiki/Villous_adenoma" class="mw-redirect" title="Villous adenoma">Villous adenoma</a> </th> <td><b>15%</b><sup id="cite_ref-Ramji2016_16-0" class="reference"><a href="#cite_note-Ramji2016-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> to <b>40%</b><sup id="cite_ref-AmersiAgustin2005_15-1" class="reference"><a href="#cite_note-AmersiAgustin2005-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </td> <td>Over 75% villous<sup id="cite_ref-WHO_14-2" class="reference"><a href="#cite_note-WHO-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </td> <td><span typeof="mw:File"><a href="/wiki/File:Villous_adenoma_of_the_colorectum_(high_power_view).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/27/Villous_adenoma_of_the_colorectum_%28high_power_view%29.jpg/180px-Villous_adenoma_of_the_colorectum_%28high_power_view%29.jpg" decoding="async" width="180" height="116" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/27/Villous_adenoma_of_the_colorectum_%28high_power_view%29.jpg/270px-Villous_adenoma_of_the_colorectum_%28high_power_view%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/27/Villous_adenoma_of_the_colorectum_%28high_power_view%29.jpg/360px-Villous_adenoma_of_the_colorectum_%28high_power_view%29.jpg 2x" data-file-width="1664" data-file-height="1071" /></a></span> </td></tr> <tr> <th><a href="/wiki/Sessile_serrated_adenoma" class="mw-redirect" title="Sessile serrated adenoma">Sessile serrated adenoma</a> (SSA)<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </th> <td> </td> <td colspan="2"> <ul><li>Basal dilation of the crypts</li> <li>Basal crypt serration</li> <li>Crypts that run horizontal to the basement membrane (horizontal crypts)</li> <li>Crypt branching.</li></ul> </td> <td><span typeof="mw:File"><a href="/wiki/File:Sessile_Serrated_Adenoma,_Transverse_Colon,_0.4_cm_(3632298679).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Sessile_Serrated_Adenoma%2C_Transverse_Colon%2C_0.4_cm_%283632298679%29.jpg/180px-Sessile_Serrated_Adenoma%2C_Transverse_Colon%2C_0.4_cm_%283632298679%29.jpg" decoding="async" width="180" height="108" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Sessile_Serrated_Adenoma%2C_Transverse_Colon%2C_0.4_cm_%283632298679%29.jpg/270px-Sessile_Serrated_Adenoma%2C_Transverse_Colon%2C_0.4_cm_%283632298679%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Sessile_Serrated_Adenoma%2C_Transverse_Colon%2C_0.4_cm_%283632298679%29.jpg/360px-Sessile_Serrated_Adenoma%2C_Transverse_Colon%2C_0.4_cm_%283632298679%29.jpg 2x" data-file-width="1603" data-file-height="964" /></a></span> </td></tr> <tr> <th><a href="/wiki/Colorectal_adenocarcinoma" class="mw-redirect" title="Colorectal adenocarcinoma">Colorectal adenocarcinoma</a> </th> <td><b>100%</b> </td> <td colspan="2"> <ul><li>In carcinoma in situ (Tis): cancer cells invading into the lamina propria, and may involve but not penetrate the muscularis mucosae. Can be classified as "high-grade dysplasia", because prognosis and management are essentially the same.<sup id="cite_ref-UpToDate_10-1" class="reference"><a href="#cite_note-UpToDate-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li> <li>Invasive adenocarcinoma: Extending through the muscularis mucosae into the submucosa and beyond.<sup id="cite_ref-UpToDate_10-2" class="reference"><a href="#cite_note-UpToDate-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li></ul> </td> <td><span typeof="mw:File"><a href="/wiki/File:Adenocarcinoma_highly_differentiated_(rectum)_H%26E_magn_400x.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Adenocarcinoma_highly_differentiated_%28rectum%29_H%26E_magn_400x.jpg/180px-Adenocarcinoma_highly_differentiated_%28rectum%29_H%26E_magn_400x.jpg" decoding="async" width="180" height="144" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Adenocarcinoma_highly_differentiated_%28rectum%29_H%26E_magn_400x.jpg/270px-Adenocarcinoma_highly_differentiated_%28rectum%29_H%26E_magn_400x.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Adenocarcinoma_highly_differentiated_%28rectum%29_H%26E_magn_400x.jpg/360px-Adenocarcinoma_highly_differentiated_%28rectum%29_H%26E_magn_400x.jpg 2x" data-file-width="1280" data-file-height="1024" /></a></span> </td></tr></tbody></table> <div class="mw-heading mw-heading3"><h3 id="Hyperplastic_polyp">Hyperplastic polyp</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=10" title="Edit section: Hyperplastic polyp"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Hyperplastic_polyp" title="Hyperplastic polyp">Hyperplastic polyp</a></div> <p>Most hyperplastic polyps are found in the <a href="/wiki/Anatomical_terms_of_location#Proximal_and_distal" title="Anatomical terms of location">distal</a> <a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">colon</a> and <a href="/wiki/Rectum" title="Rectum">rectum</a>.<sup id="cite_ref-Robbins_polyps_18-0" class="reference"><a href="#cite_note-Robbins_polyps-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> They have no malignant potential,<sup id="cite_ref-Robbins_polyps_18-1" class="reference"><a href="#cite_note-Robbins_polyps-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> which means that they are no more likely than normal tissue to eventually become a cancer. </p> <div class="mw-heading mw-heading3"><h3 id="Neoplastic_polyp">Neoplastic polyp</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=11" title="Edit section: Neoplastic polyp"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A <a href="/wiki/Neoplasm" title="Neoplasm">neoplasm</a> is a tissue whose cells have lost normal <a href="/wiki/Cellular_differentiation" title="Cellular differentiation">differentiation</a>. They can be either benign growths or malignant growths. The malignant growths can either have primary or secondary causes. Adenomatous polyps are considered precursors to cancer and cancer becomes invasive once malignant cells cross the muscularis mucosa and invade the cells below.<sup id="cite_ref-:1_9-27" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Any cellular changes seen above the lamina propria are considered non-invasive and are labeled atypia or dysplasia. Any invasive carcinoma that has penetrated the muscularis mocos has the potential for lymph node metastasis and local recurrence which will require more aggressive and extensive resection.<sup id="cite_ref-:1_9-28" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The Haggitt's criteria is used for classification of polyps containing cancer and is based on the depth of penetration.<sup id="cite_ref-:1_9-29" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The Haggitt's criteria has level 0 through level 4, with all invasive carcinoma of sessile polyp variant by definition being classified as level 4.<sup id="cite_ref-:1_9-30" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Level 0: Cancer does not penetrate through the muscularis mucosa.<sup id="cite_ref-:1_9-31" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li> <li>Level 1: Cancer penetrates through the muscularis mucosa and invades the submucosa below but is limited to the head of the polyp.<sup id="cite_ref-:1_9-32" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li> <li>Level 2: Cancer invades through with involvement of the neck of polyp.<sup id="cite_ref-:1_9-33" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li> <li>Level 3: Cancer invades through with involvement of any parts of the stalk.<sup id="cite_ref-:1_9-34" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li> <li>Level 4: Cancer invades through the submucosa below the stalk of the polyp but above the muscularis propria of the bowel wall.<sup id="cite_ref-:1_9-35" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading4"><h4 id="Adenomas">Adenomas</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=12" title="Edit section: Adenomas"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Colorectal_adenoma" title="Colorectal adenoma">Colorectal adenoma</a></div> <p>Neoplastic polyps of the <a href="/wiki/Bowel" class="mw-redirect" title="Bowel">bowel</a> are often benign hence called adenomas. An adenoma is a tumor of glandular tissue, that has not (yet) gained the properties of cancer.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2020)">citation needed</span></a></i>]</sup> </p><p>The common adenomas of the colon (<a href="/wiki/Colorectal_adenoma" title="Colorectal adenoma">colorectal adenoma</a>) are the <a href="/wiki/Tubular_adenoma" class="mw-redirect" title="Tubular adenoma">tubular</a>, <a href="/wiki/Tubulovillous_adenoma" class="mw-redirect" title="Tubulovillous adenoma">tubulovillous</a>, <a href="/wiki/Villous_adenoma" class="mw-redirect" title="Villous adenoma">villous</a>, and <a href="/wiki/Sessile_serrated_adenoma" class="mw-redirect" title="Sessile serrated adenoma">sessile serrated</a> (SSA).<sup id="cite_ref-Robbins_polyps_18-2" class="reference"><a href="#cite_note-Robbins_polyps-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> A large majority (65–80%) are of the benign tubular type with 10–25% being tubulovillous, and villous being the most rare at 5–10%.<sup id="cite_ref-:1_9-36" class="reference"><a href="#cite_note-:1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>As is evident from their name, sessile serrated and traditional serrated adenomas (TSAs) have a serrated appearance and can be difficult to distinguish microscopically from hyperplastic polyps.<sup id="cite_ref-Robbins_polyps_18-3" class="reference"><a href="#cite_note-Robbins_polyps-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Making this distinction is important, however, since SSAs and TSAs have the potential to become cancers,<sup id="cite_ref-Sternberg_19-0" class="reference"><a href="#cite_note-Sternberg-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> while hyperplastic polyps do not.<sup id="cite_ref-Robbins_polyps_18-4" class="reference"><a href="#cite_note-Robbins_polyps-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>The villous subdivision is associated with the highest malignant potential because they generally have the largest surface area. (This is because the villi are projections into the lumen and hence have a bigger surface area.) However, villous adenomas are no more likely than tubular or tubulovillous adenomas to become cancerous if their sizes are all the same.<sup id="cite_ref-Robbins_polyps_18-5" class="reference"><a href="#cite_note-Robbins_polyps-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Hamartomatous_polyp">Hamartomatous polyp</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=13" title="Edit section: Hamartomatous polyp"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Hamartomatous polyps are tumours, like growths found in organs as a result of faulty development. They are normally made up of a mixture of tissues. They contain mucus-filled glands, with retention cysts, abundant connective tissue, and chronic cellular infiltration of eosinophils.<sup id="cite_ref-pmid18672141_20-0" class="reference"><a href="#cite_note-pmid18672141-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> They grow at the normal rate of the host tissue and rarely cause problems such as compression. A common example of a hamartomatous lesion is a <a href="/wiki/Strawberry_naevus" class="mw-redirect" title="Strawberry naevus">strawberry naevus</a>. Hamartomatous polyps are often found by chance; occurring in syndromes such as Peutz–Jegher syndrome or Juvenile polyposis syndrome. </p><p><i><a href="/wiki/Peutz%E2%80%93Jeghers_syndrome" title="Peutz–Jeghers syndrome">Peutz–Jeghers syndrome</a></i> is associated with polyps of the GI tract and also increased pigmentation around the lips, genitalia, buccal mucosa feet and hands. People are often diagnosed with Peutz–Jegher after presenting at around the age of nine with an intussusception. The polyps themselves carry little malignant potential but because of potential coexisting adenomas there is a 15% chance of colonic malignancy. </p><p><i><a href="/wiki/Juvenile_polyps" class="mw-redirect" title="Juvenile polyps">Juvenile polyps</a></i> are hamartomatous polyps that often become evident before twenty years of age, but can also be seen in adults. They are usually solitary polyps found in the <a href="/wiki/Rectum" title="Rectum">rectum</a> which most commonly present with rectal bleeding. <a href="/wiki/Juvenile_polyposis_syndrome" title="Juvenile polyposis syndrome">Juvenile polyposis syndrome</a> is characterised by the presence of more than five polyps in the colon or rectum, or numerous juvenile polyps throughout the <a href="/wiki/Gastrointestinal_tract" title="Gastrointestinal tract">gastrointestinal tract</a>, or any number of juvenile polyps in any person with a family history of juvenile polyposis. People with juvenile polyposis have an increased risk of colon cancer.<sup id="cite_ref-Sternberg_19-1" class="reference"><a href="#cite_note-Sternberg-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Inflammatory_polyp">Inflammatory polyp</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=14" title="Edit section: Inflammatory polyp"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>These are polyps that are associated with inflammatory conditions such as <a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">ulcerative colitis</a> and <a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=15" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Diet and lifestyle are believed to play a large role in whether colorectal polyps form. Studies show there to be a protective link between consumption of cooked green vegetables, brown rice, legumes, and dried fruit and decreased incidence of colorectal polyps.<sup id="cite_ref-pmid21547850_21-0" class="reference"><a href="#cite_note-pmid21547850-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=16" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Colorectal polyps can be detected using a <a href="/wiki/Faecal_occult_blood" class="mw-redirect" title="Faecal occult blood">faecal occult blood</a> test, flexible <a href="/wiki/Sigmoidoscopy" title="Sigmoidoscopy">sigmoidoscopy</a>, <a href="/wiki/Colonoscopy" title="Colonoscopy">colonoscopy</a>, <a href="/wiki/Virtual_colonoscopy" title="Virtual colonoscopy">virtual colonoscopy</a>, <a href="/wiki/Digital_rectal_examination" class="mw-redirect" title="Digital rectal examination">digital rectal examination</a>, <a href="/wiki/Barium_enema" class="mw-redirect" title="Barium enema">barium enema</a> or a <a href="/wiki/Pill_camera" class="mw-redirect" title="Pill camera">pill camera</a>.<sup id="cite_ref-mayo_3-3" class="reference"><a href="#cite_note-mayo-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability"><span title="The material near this tag failed verification of its source citation(s). (January 2020)">failed verification</span></a></i>]</sup> </p><p>Malignant potential is associated with </p> <ul><li>degree of <a href="/wiki/Dysplasia" title="Dysplasia">dysplasia</a></li> <li>Type of polyp (e.g. <a href="/wiki/Villous_adenoma" class="mw-redirect" title="Villous adenoma">villous adenoma</a>): <ul><li>Tubular adenoma: 5% risk of cancer</li> <li>Tubulovillous adenoma: 20% risk of cancer</li> <li>Villous adenoma: 40% risk of cancer</li></ul></li> <li>Size of polyp: <ul><li><1 cm =<1% risk of cancer<sup id="cite_ref-pmid20501711_22-0" class="reference"><a href="#cite_note-pmid20501711-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup></li> <li>1–2 cm=10% risk of cancer<sup id="cite_ref-pmid20501711_22-1" class="reference"><a href="#cite_note-pmid20501711-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup></li> <li>>2 cm=50% risk of cancer<sup id="cite_ref-pmid20501711_22-2" class="reference"><a href="#cite_note-pmid20501711-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup></li></ul></li></ul> <p>Normally an adenoma that is greater than 0.5 cm is treated. </p> <div class="mw-heading mw-heading3"><h3 id="Gallery">Gallery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=17" title="Edit section: Gallery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><span class="anchor" id="Paris_classification"></span> </p> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 92px"> <div class="thumb" style="width: 90px;"><span typeof="mw:File"><a href="/wiki/File:Hyperplastic_polyp1.jpg" class="mw-file-description" title="Microvesicular hyperplastic polyp. H&E stain."><img alt="Microvesicular hyperplastic polyp. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Hyperplastic_polyp1.jpg/135px-Hyperplastic_polyp1.jpg" decoding="async" width="90" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Hyperplastic_polyp1.jpg/202px-Hyperplastic_polyp1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Hyperplastic_polyp1.jpg/270px-Hyperplastic_polyp1.jpg 2x" data-file-width="1536" data-file-height="2048" /></a></span></div> <div class="gallerytext">Microvesicular hyperplastic polyp. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>.</div> </li> <li class="gallerybox" style="width: 156.66666666667px"> <div class="thumb" style="width: 154.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Hyperplastic_polyp2.jpg" class="mw-file-description" title="Microvesicular hyperplastic polyp. H&E stain."><img alt="Microvesicular hyperplastic polyp. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/0/06/Hyperplastic_polyp2.jpg/232px-Hyperplastic_polyp2.jpg" decoding="async" width="155" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/06/Hyperplastic_polyp2.jpg/348px-Hyperplastic_polyp2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/06/Hyperplastic_polyp2.jpg/464px-Hyperplastic_polyp2.jpg 2x" data-file-width="1536" data-file-height="1192" /></a></span></div> <div class="gallerytext">Microvesicular hyperplastic polyp. H&E stain.</div> </li> <li class="gallerybox" style="width: 182px"> <div class="thumb" style="width: 180px;"><span typeof="mw:File"><a href="/wiki/File:Traditional_serrated_adenoma_intermed_mag.jpg" class="mw-file-description" title="Traditional serrated adenoma. H&E stain."><img alt="Traditional serrated adenoma. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Traditional_serrated_adenoma_intermed_mag.jpg/270px-Traditional_serrated_adenoma_intermed_mag.jpg" decoding="async" width="180" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Traditional_serrated_adenoma_intermed_mag.jpg/405px-Traditional_serrated_adenoma_intermed_mag.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Traditional_serrated_adenoma_intermed_mag.jpg/540px-Traditional_serrated_adenoma_intermed_mag.jpg 2x" data-file-width="4272" data-file-height="2848" /></a></span></div> <div class="gallerytext">Traditional serrated adenoma. H&E stain.</div> </li> <li class="gallerybox" style="width: 194.66666666667px"> <div class="thumb" style="width: 192.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Colon_cancer.jpg" class="mw-file-description" title="Gross appearance of a colectomy specimen containing two colorectal polyps and one invasive colorectal carcinoma"><img alt="Gross appearance of a colectomy specimen containing two colorectal polyps and one invasive colorectal carcinoma" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/44/Colon_cancer.jpg/289px-Colon_cancer.jpg" decoding="async" width="193" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/44/Colon_cancer.jpg/433px-Colon_cancer.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/44/Colon_cancer.jpg/577px-Colon_cancer.jpg 2x" data-file-width="663" data-file-height="414" /></a></span></div> <div class="gallerytext"><a href="/wiki/Gross_examination" class="mw-redirect" title="Gross examination">Gross</a> appearance of a <a href="/wiki/Colectomy" title="Colectomy">colectomy</a> specimen containing two colorectal polyps and one invasive <a href="/wiki/Colorectal_cancer" title="Colorectal cancer">colorectal carcinoma</a></div> </li> <li class="gallerybox" style="width: 182px"> <div class="thumb" style="width: 180px;"><span typeof="mw:File"><a href="/wiki/File:Tubular_adenoma_2_high_mag.jpg" class="mw-file-description" title="Micrograph of a tubular adenoma, the most common type of dysplastic polyp in the colon"><img alt="Micrograph of a tubular adenoma, the most common type of dysplastic polyp in the colon" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Tubular_adenoma_2_high_mag.jpg/270px-Tubular_adenoma_2_high_mag.jpg" decoding="async" width="180" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Tubular_adenoma_2_high_mag.jpg/405px-Tubular_adenoma_2_high_mag.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Tubular_adenoma_2_high_mag.jpg/540px-Tubular_adenoma_2_high_mag.jpg 2x" data-file-width="4272" data-file-height="2848" /></a></span></div> <div class="gallerytext"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of a <a href="/wiki/Tubular_adenoma" class="mw-redirect" title="Tubular adenoma">tubular adenoma</a>, the most common type of dysplastic polyp in the colon</div> </li> <li class="gallerybox" style="width: 162px"> <div class="thumb" style="width: 160px;"><span typeof="mw:File"><a href="/wiki/File:Sessile_serrated_adenoma.jpg" class="mw-file-description" title="Micrograph of a sessile serrated adenoma. H&E stain."><img alt="Micrograph of a sessile serrated adenoma. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Sessile_serrated_adenoma.jpg/240px-Sessile_serrated_adenoma.jpg" decoding="async" width="160" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Sessile_serrated_adenoma.jpg/360px-Sessile_serrated_adenoma.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Sessile_serrated_adenoma.jpg/480px-Sessile_serrated_adenoma.jpg 2x" data-file-width="2048" data-file-height="1536" /></a></span></div> <div class="gallerytext"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of a <a href="/wiki/Sessile_serrated_adenoma" class="mw-redirect" title="Sessile serrated adenoma">sessile serrated adenoma</a>. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>.</div> </li> <li class="gallerybox" style="width: 94.666666666667px"> <div class="thumb" style="width: 92.666666666667px;"><span typeof="mw:File"><a href="/wiki/File:Peutz-Jeghers_syndrome_polyp.jpg" class="mw-file-description" title="Micrograph of a Peutz–Jeghers colonic polyp – a type of hamartomatous polyp. H&E stain."><img alt="Micrograph of a Peutz–Jeghers colonic polyp – a type of hamartomatous polyp. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c6/Peutz-Jeghers_syndrome_polyp.jpg/139px-Peutz-Jeghers_syndrome_polyp.jpg" decoding="async" width="93" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c6/Peutz-Jeghers_syndrome_polyp.jpg/208px-Peutz-Jeghers_syndrome_polyp.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c6/Peutz-Jeghers_syndrome_polyp.jpg/277px-Peutz-Jeghers_syndrome_polyp.jpg 2x" data-file-width="2472" data-file-height="3208" /></a></span></div> <div class="gallerytext"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of a <a href="/wiki/Peutz%E2%80%93Jeghers_syndrome" title="Peutz–Jeghers syndrome">Peutz–Jeghers colonic polyp</a> – a type of hamartomatous polyp. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>.</div> </li> <li class="gallerybox" style="width: 162px"> <div class="thumb" style="width: 160px;"><span typeof="mw:File"><a href="/wiki/File:Tubular_adenoma_high_mag.jpg" class="mw-file-description" title="Micrograph of a tubular adenoma – dysplastic epithelium (dark purple) on left of image; normal epithelium (blue) on right. H&E stain."><img alt="Micrograph of a tubular adenoma – dysplastic epithelium (dark purple) on left of image; normal epithelium (blue) on right. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/c/ce/Tubular_adenoma_high_mag.jpg/240px-Tubular_adenoma_high_mag.jpg" decoding="async" width="160" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/ce/Tubular_adenoma_high_mag.jpg/360px-Tubular_adenoma_high_mag.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/ce/Tubular_adenoma_high_mag.jpg/480px-Tubular_adenoma_high_mag.jpg 2x" data-file-width="2048" data-file-height="1536" /></a></span></div> <div class="gallerytext"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of a <i>tubular adenoma</i> – <a href="/wiki/Dysplasia" title="Dysplasia">dysplastic</a> epithelium (dark purple) on left of image; normal epithelium (blue) on right. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>.</div> </li> <li class="gallerybox" style="width: 162px"> <div class="thumb" style="width: 160px;"><span typeof="mw:File"><a href="/wiki/File:Villous_adenoma1.jpg" class="mw-file-description" title="Micrograph of a villous adenoma. These polyps are considered to have a high risk of malignant transformation. H&E stain."><img alt="Micrograph of a villous adenoma. These polyps are considered to have a high risk of malignant transformation. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1a/Villous_adenoma1.jpg/240px-Villous_adenoma1.jpg" decoding="async" width="160" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1a/Villous_adenoma1.jpg/360px-Villous_adenoma1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1a/Villous_adenoma1.jpg/480px-Villous_adenoma1.jpg 2x" data-file-width="2048" data-file-height="1536" /></a></span></div> <div class="gallerytext"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of a <a href="/wiki/Villous_adenoma" class="mw-redirect" title="Villous adenoma">villous adenoma</a>. These polyps are considered to have a high risk of malignant transformation. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>.</div> </li> <li class="gallerybox" style="width: 482.66666666667px"> <div class="thumb" style="width: 480.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Paris_classification_of_colorectal_neoplasms.jpg" class="mw-file-description" title="Paris classification of colorectal neoplasms[23]"><img alt="Paris classification of colorectal neoplasms." src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8c/Paris_classification_of_colorectal_neoplasms.jpg/721px-Paris_classification_of_colorectal_neoplasms.jpg" decoding="async" width="481" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8c/Paris_classification_of_colorectal_neoplasms.jpg/1081px-Paris_classification_of_colorectal_neoplasms.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8c/Paris_classification_of_colorectal_neoplasms.jpg/1441px-Paris_classification_of_colorectal_neoplasms.jpg 2x" data-file-width="6757" data-file-height="1689" /></a></span></div> <div class="gallerytext">Paris classification of colorectal neoplasms<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup></div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="NICE_classification">NICE classification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=18" title="Edit section: NICE classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In <a href="/wiki/Colonoscopy" title="Colonoscopy">colonoscopy</a>, colorectal polyps can be classified by NICE (<a href="/wiki/Narrow-band_imaging" title="Narrow-band imaging">Narrow-band imaging</a> International Colorectal Endoscopic):<sup id="cite_ref-Hattori2014_24-0" class="reference"><a href="#cite_note-Hattori2014-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable" align="center"> <tbody><tr> <th></th> <th>Type 1</th> <th>Type 2</th> <th>Type 3 </th></tr> <tr> <th>Color </th> <td>Same or lighter than background</td> <td>Browner than background</td> <td>Browner or darkly browner than background, sometimes patchy whiter areas </td></tr> <tr> <th>Vessels </th> <td>None, or isolated lacy vessels coursing across the lesion</td> <td>Brown vessels surrounding white structures</td> <td>Area of disrupted or missing vessels </td></tr> <tr> <th>Surface Pattern </th> <td>Homogenous, or dark or white spots of uniform size</td> <td>Oval, tubular or branched white structures surrounded by brown vessels</td> <td>Amorphous or absent surface pattern </td></tr> <tr> <th>Most likely pathology </th> <td>Hyperplasia</td> <td>Adenoma</td> <td>Deep submucosal invasive cancer </td></tr> <tr> <th>Treatment </th> <td>Follow up</td> <td>Mucosal or submucosal polypectomy</td> <td>Surgical operation </td></tr></tbody></table> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=19" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Polyps can be removed during a <a href="/wiki/Colonoscopy" title="Colonoscopy">colonoscopy</a> or <a href="/wiki/Sigmoidoscopy" title="Sigmoidoscopy">sigmoidoscopy</a> using a wire loop that cuts the stalk of the polyp and <a href="/wiki/Cauterise" class="mw-redirect" title="Cauterise">cauterises</a> it to prevent bleeding.<sup id="cite_ref-mayo_3-4" class="reference"><a href="#cite_note-mayo-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability"><span title="The material near this tag failed verification of its source citation(s). (January 2020)">failed verification</span></a></i>]</sup> Many "defiant" polyps—large, flat, and otherwise laterally spreading <a href="/wiki/Adenomas" class="mw-redirect" title="Adenomas">adenomas</a>—may be removed <a href="/wiki/Endoscope" title="Endoscope">endoscopically</a> by a technique called <a href="/wiki/Endoscopic_mucosal_resection" title="Endoscopic mucosal resection">endoscopic mucosal resection</a> (EMR), which involves injection of fluid underneath the lesion to lift it and thus facilitate endoscopic resection. Saline water may be used to generate lift, though some injectable solutions such as SIC 8000 may be more effective.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Minimally invasive surgery is indicated for polyps that are too large or in unfavorable locations, such as the appendix, that cannot be removed endoscopically.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> These techniques may be employed as an alternative to the more invasive <a href="/wiki/Colectomy" title="Colectomy">colectomy</a>.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Follow-up">Follow-up</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=20" title="Edit section: Follow-up"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>By <a href="/wiki/United_States" title="United States">United States</a> guidelines, the following follow-up is recommended:<sup id="cite_ref-GuptaLieberman2020_28-0" class="reference"><a href="#cite_note-GuptaLieberman2020-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <tbody><tr> <th>Baseline colonoscopy finding</th> <th>Recommended time until next colonoscopy </th></tr> <tr> <td>Normal</td> <td>10 years </td></tr> <tr> <td>1–2 tubular adenomas <10 mm</td> <td>7–10 years </td></tr> <tr> <td>3–4 tubular adenomas <10 mm</td> <td>3–5 years </td></tr> <tr> <td> <ul><li>5–10 tubular adenomas <10 mm and/or</li> <li>Adenoma 10 mm and/or</li> <li>Adenoma with tubulovillous or villous histology and/or</li> <li>Adenoma with high-grade dysplasia</li></ul> </td> <td>3 years </td></tr> <tr> <td>>10 adenomas on single examination</td> <td>1 years </td></tr> <tr> <td>Piecemeal resection of adenoma 20 mm</td> <td>6 months </td></tr></tbody></table> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Colorectal_polyp&action=edit&section=21" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-MedNet-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-MedNet_1-0">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output 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Elsevier: 10–26. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.mam.2019.03.001">10.1016/j.mam.2019.03.001</a></span>. <a href="/wiki/Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/2445%2F171217">2445/171217</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30862463">30862463</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Molecular+Aspects+of+Medicine&rft.atitle=Update+on+genetic+predisposition+to+colorectal+cancer+and+polyposis&rft.volume=69&rft.pages=10-26&rft.date=2019-10&rft_id=info%3Ahdl%2F2445%2F171217&rft_id=info%3Apmid%2F30862463&rft_id=info%3Adoi%2F10.1016%2Fj.mam.2019.03.001&rft.aulast=Valle&rft.aufirst=L&rft.au=de+Voer%2C+RM&rft.au=Goldberg%2C+Y&rft.au=Sjursen%2C+W&rft.au=F%C3%B6rsti%2C+A&rft.au=Ruiz-Ponte%2C+C&rft.au=Cald%C3%A9s%2C+T&rft.au=Garr%C3%A9%2C+P&rft.au=Olsen%2C+MF&rft.au=Nordling%2C+M&rft.au=Castellvi-Bel%2C+S&rft.au=Hemminmki%2C+K&rft_id=https%3A%2F%2Fdoi.org%2F10.1016%252Fj.mam.2019.03.001&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-:1-9"><span class="mw-cite-backlink">^ <a href="#cite_ref-:1_9-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:1_9-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:1_9-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:1_9-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:1_9-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-:1_9-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-:1_9-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-:1_9-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-:1_9-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-:1_9-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-:1_9-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-:1_9-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-:1_9-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-:1_9-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-:1_9-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-:1_9-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-:1_9-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-:1_9-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-:1_9-18"><sup><i><b>s</b></i></sup></a> <a href="#cite_ref-:1_9-19"><sup><i><b>t</b></i></sup></a> <a href="#cite_ref-:1_9-20"><sup><i><b>u</b></i></sup></a> <a href="#cite_ref-:1_9-21"><sup><i><b>v</b></i></sup></a> <a href="#cite_ref-:1_9-22"><sup><i><b>w</b></i></sup></a> <a href="#cite_ref-:1_9-23"><sup><i><b>x</b></i></sup></a> <a href="#cite_ref-:1_9-24"><sup><i><b>y</b></i></sup></a> <a href="#cite_ref-:1_9-25"><sup><i><b>z</b></i></sup></a> <a href="#cite_ref-:1_9-26"><sup><i><b>aa</b></i></sup></a> <a href="#cite_ref-:1_9-27"><sup><i><b>ab</b></i></sup></a> <a href="#cite_ref-:1_9-28"><sup><i><b>ac</b></i></sup></a> <a href="#cite_ref-:1_9-29"><sup><i><b>ad</b></i></sup></a> <a href="#cite_ref-:1_9-30"><sup><i><b>ae</b></i></sup></a> <a href="#cite_ref-:1_9-31"><sup><i><b>af</b></i></sup></a> <a href="#cite_ref-:1_9-32"><sup><i><b>ag</b></i></sup></a> <a href="#cite_ref-:1_9-33"><sup><i><b>ah</b></i></sup></a> <a href="#cite_ref-:1_9-34"><sup><i><b>ai</b></i></sup></a> <a href="#cite_ref-:1_9-35"><sup><i><b>aj</b></i></sup></a> <a href="#cite_ref-:1_9-36"><sup><i><b>ak</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMahmoudBleierAaronsPaulson2017" class="citation book cs1">Mahmoud, Najjia N.; Bleier, Joshua I.S.; Aarons, Cary B.; Paulson, E. Carter; Shanmugan, Skandan; Fry, Robert D. (2017). <i>Sabiston Textbook of Surgery</i> (20th ed.). Elsevier. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9780323401630" title="Special:BookSources/9780323401630"><bdi>9780323401630</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Sabiston+Textbook+of+Surgery&rft.edition=20th&rft.pub=Elsevier&rft.date=2017&rft.isbn=9780323401630&rft.aulast=Mahmoud&rft.aufirst=Najjia+N.&rft.au=Bleier%2C+Joshua+I.S.&rft.au=Aarons%2C+Cary+B.&rft.au=Paulson%2C+E.+Carter&rft.au=Shanmugan%2C+Skandan&rft.au=Fry%2C+Robert+D.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources"><span title="This citation requires a reference to the specific page or range of pages in which the material appears. (August 2019)">page needed</span></a></i>]</sup></span> </li> <li id="cite_note-UpToDate-10"><span class="mw-cite-backlink">^ <a href="#cite_ref-UpToDate_10-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-UpToDate_10-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-UpToDate_10-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFinlay_A_Macrae" class="citation web cs1">Finlay A Macrae. <a rel="nofollow" class="external text" href="https://www.uptodate.com/contents/overview-of-colon-polyps#H695577522">"Overview of colon polyps"</a>. <i>UpToDate</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=UpToDate&rft.atitle=Overview+of+colon+polyps&rft.au=Finlay+A+Macrae&rft_id=https%3A%2F%2Fwww.uptodate.com%2Fcontents%2Foverview-of-colon-polyps%23H695577522&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span> This topic last updated: Dec 10, 2018.</span> </li> <li id="cite_note-Stanford-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-Stanford_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Stanford_11-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Stanford_11-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRobert_V_Rouse2010" class="citation web cs1">Robert V Rouse (2010-01-31). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20191211031701/http://surgpathcriteria.stanford.edu/gitumors/colorectal-hyperplastic-polyp/">"Hyperplastic Polyp of the Colon and Rectum"</a>. <i>Stanford University School of Medicine</i>. Archived from <a rel="nofollow" class="external text" href="http://surgpathcriteria.stanford.edu/gitumors/colorectal-hyperplastic-polyp/">the original</a> on 2019-12-11<span class="reference-accessdate">. Retrieved <span class="nowrap">2019-10-31</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Stanford+University+School+of+Medicine&rft.atitle=Hyperplastic+Polyp+of+the+Colon+and+Rectum&rft.date=2010-01-31&rft.au=Robert+V+Rouse&rft_id=http%3A%2F%2Fsurgpathcriteria.stanford.edu%2Fgitumors%2Fcolorectal-hyperplastic-polyp%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span> Last updated 6/2/2015</span> </li> <li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMinhhuyen_Nguyen" class="citation web cs1">Minhhuyen Nguyen. <a rel="nofollow" class="external text" href="https://www.msdmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gastrointestinal-tract/polyps-of-the-colon-and-rectum">"Polyps of the Colon and Rectum"</a>. <i>MSD Manual</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=MSD+Manual&rft.atitle=Polyps+of+the+Colon+and+Rectum&rft.au=Minhhuyen+Nguyen&rft_id=https%3A%2F%2Fwww.msdmanuals.com%2Fprofessional%2Fgastrointestinal-disorders%2Ftumors-of-the-gastrointestinal-tract%2Fpolyps-of-the-colon-and-rectum&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span> Last full review/revision June 2019</span> </li> <li id="cite_note-stanford-criteria-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-stanford-criteria_13-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRobert_V_Rouse" class="citation web cs1">Robert V Rouse. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20190911021007/http://surgpathcriteria.stanford.edu/gitumors/colorectal-adenoma/">"Adenoma of the Colon and Rectum"</a>. Archived from <a rel="nofollow" class="external text" href="http://surgpathcriteria.stanford.edu/gitumors/colorectal-adenoma/">the original</a> on 2019-09-11<span class="reference-accessdate">. Retrieved <span class="nowrap">2019-10-31</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Adenoma+of+the+Colon+and+Rectum&rft.au=Robert+V+Rouse&rft_id=http%3A%2F%2Fsurgpathcriteria.stanford.edu%2Fgitumors%2Fcolorectal-adenoma%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span> Original posting/last update : 1/31/10, 1/19/14</span> </li> <li id="cite_note-WHO-14"><span class="mw-cite-backlink">^ <a href="#cite_ref-WHO_14-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-WHO_14-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-WHO_14-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBosman2010" class="citation book cs1">Bosman, F. T. (2010). <i>WHO classification of tumours of the digestive system</i>. Lyon: International Agency for Research on Cancer. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-92-832-2432-7" title="Special:BookSources/978-92-832-2432-7"><bdi>978-92-832-2432-7</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/688585784">688585784</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=WHO+classification+of+tumours+of+the+digestive+system&rft.place=Lyon&rft.pub=International+Agency+for+Research+on+Cancer&rft.date=2010&rft_id=info%3Aoclcnum%2F688585784&rft.isbn=978-92-832-2432-7&rft.aulast=Bosman&rft.aufirst=F.+T.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-AmersiAgustin2005-15"><span class="mw-cite-backlink">^ <a href="#cite_ref-AmersiAgustin2005_15-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-AmersiAgustin2005_15-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAmersiAgustinKo2005" class="citation journal cs1">Amersi, Farin; Agustin, Michelle; Ko, Clifford Y (2005). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780097">"Colorectal Cancer: Epidemiology, Risk Factors, and Health Services"</a>. <i>Clinics in Colon and Rectal Surgery</i>. <b>18</b> (3): 133–140. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1055%2Fs-2005-916274">10.1055/s-2005-916274</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1531-0043">1531-0043</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780097">2780097</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20011296">20011296</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinics+in+Colon+and+Rectal+Surgery&rft.atitle=Colorectal+Cancer%3A+Epidemiology%2C+Risk+Factors%2C+and+Health+Services&rft.volume=18&rft.issue=3&rft.pages=133-140&rft.date=2005&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2780097%23id-name%3DPMC&rft.issn=1531-0043&rft_id=info%3Apmid%2F20011296&rft_id=info%3Adoi%2F10.1055%2Fs-2005-916274&rft.aulast=Amersi&rft.aufirst=Farin&rft.au=Agustin%2C+Michelle&rft.au=Ko%2C+Clifford+Y&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2780097&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-Ramji2016-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-Ramji2016_16-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAlnoor_Ramji2022" class="citation journal cs1">Alnoor Ramji (22 December 2022). <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/170283-followup#e3">"Villous Adenoma Follow-up"</a>. <i>Medscape</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Medscape&rft.atitle=Villous+Adenoma+Follow-up&rft.date=2022-12-22&rft.au=Alnoor+Ramji&rft_id=https%3A%2F%2Femedicine.medscape.com%2Farticle%2F170283-followup%23e3&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span> Updated: Oct 24, 2016</span> </li> <li id="cite_note-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-17">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRostyHewettBrownLeggett2013" class="citation journal cs1">Rosty, C; Hewett, D. G.; Brown, I. S.; Leggett, B. A.; Whitehall, V. L. (2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698429">"Serrated polyps of the large intestine: Current understanding of diagnosis, pathogenesis, and clinical management"</a>. <i>Journal of Gastroenterology</i>. <b>48</b> (3): 287–302. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00535-012-0720-y">10.1007/s00535-012-0720-y</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698429">3698429</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23208018">23208018</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Gastroenterology&rft.atitle=Serrated+polyps+of+the+large+intestine%3A+Current+understanding+of+diagnosis%2C+pathogenesis%2C+and+clinical+management&rft.volume=48&rft.issue=3&rft.pages=287-302&rft.date=2013&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3698429%23id-name%3DPMC&rft_id=info%3Apmid%2F23208018&rft_id=info%3Adoi%2F10.1007%2Fs00535-012-0720-y&rft.aulast=Rosty&rft.aufirst=C&rft.au=Hewett%2C+D.+G.&rft.au=Brown%2C+I.+S.&rft.au=Leggett%2C+B.+A.&rft.au=Whitehall%2C+V.+L.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3698429&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-Robbins_polyps-18"><span class="mw-cite-backlink">^ <a href="#cite_ref-Robbins_polyps_18-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Robbins_polyps_18-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Robbins_polyps_18-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Robbins_polyps_18-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Robbins_polyps_18-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Robbins_polyps_18-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKumar2010" class="citation book cs1">Kumar, Vinay (2010). <a rel="nofollow" class="external text" href="http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-0792-2..50022-5--cesec238&isbn=978-1-4377-0792-2&uniqId=278090687-4#4-u1.0-B978-1-4377-0792-2..50022-5--f46">"17—Polyps"</a>. <i>Robbins and Cotran pathologic basis of disease</i> (8th ed.). Philadelphia, PA: Saunders/Elsevier. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4160-3121-5" title="Special:BookSources/978-1-4160-3121-5"><bdi>978-1-4160-3121-5</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=17%E2%80%94Polyps&rft.btitle=Robbins+and+Cotran+pathologic+basis+of+disease.&rft.place=Philadelphia%2C+PA&rft.edition=8th&rft.pub=Saunders%2FElsevier&rft.date=2010&rft.isbn=978-1-4160-3121-5&rft.aulast=Kumar&rft.aufirst=Vinay&rft_id=http%3A%2F%2Fwww.mdconsult.com%2Fbooks%2Fpage.do%3Feid%3D4-u1.0-B978-1-4377-0792-2..50022-5--cesec238%26isbn%3D978-1-4377-0792-2%26uniqId%3D278090687-4%234-u1.0-B978-1-4377-0792-2..50022-5--f46&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-Sternberg-19"><span class="mw-cite-backlink">^ <a href="#cite_ref-Sternberg_19-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Sternberg_19-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFStoler,_Mark_A.Mills,_Stacey_E.Carter,_DarrylJoel_K._Greenson2009" class="citation book cs1">Stoler, Mark A.; Mills, Stacey E.; Carter, Darryl; Joel K. Greenson; Reuter, Victor E. (2009). <i>Sternberg's Diagnostic Surgical Pathology</i>. Hagerstwon, MD: Lippincott Williams & Wilkins. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-7817-7942-5" title="Special:BookSources/978-0-7817-7942-5"><bdi>978-0-7817-7942-5</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Sternberg%27s+Diagnostic+Surgical+Pathology&rft.place=Hagerstwon%2C+MD&rft.pub=Lippincott+Williams+%26+Wilkins&rft.date=2009&rft.isbn=978-0-7817-7942-5&rft.au=Stoler%2C+Mark+A.&rft.au=Mills%2C+Stacey+E.&rft.au=Carter%2C+Darryl&rft.au=Joel+K.+Greenson&rft.au=Reuter%2C+Victor+E.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources"><span title="This citation requires a reference to the specific page or range of pages in which the material appears. (June 2018)">page needed</span></a></i>]</sup></span> </li> <li id="cite_note-pmid18672141-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid18672141_20-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCalvaHowe2008" class="citation journal cs1">Calva, Daniel; Howe, James R (2008). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659506">"Hamartomatous Polyposis Syndromes"</a>. <i>Surgical Clinics of North America</i>. <b>88</b> (4): 779–817, vii. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.suc.2008.05.002">10.1016/j.suc.2008.05.002</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659506">2659506</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18672141">18672141</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Surgical+Clinics+of+North+America&rft.atitle=Hamartomatous+Polyposis+Syndromes&rft.volume=88&rft.issue=4&rft.pages=779-817%2C+vii&rft.date=2008&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2659506%23id-name%3DPMC&rft_id=info%3Apmid%2F18672141&rft_id=info%3Adoi%2F10.1016%2Fj.suc.2008.05.002&rft.aulast=Calva&rft.aufirst=Daniel&rft.au=Howe%2C+James+R&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2659506&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-pmid21547850-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid21547850_21-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTantamangoKnutsenBeesonFraser2011" class="citation journal cs1">Tantamango, Yessenia M; Knutsen, Synnove F; Beeson, W Lawrence; Fraser, Gary; Sabate, Joan (2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427008">"Foods and Food Groups Associated with the Incidence of Colorectal Polyps: The Adventist Health Study"</a>. <i>Nutrition and Cancer</i>. <b>63</b> (4): 565–72. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1080%2F01635581.2011.551988">10.1080/01635581.2011.551988</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427008">3427008</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21547850">21547850</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nutrition+and+Cancer&rft.atitle=Foods+and+Food+Groups+Associated+with+the+Incidence+of+Colorectal+Polyps%3A+The+Adventist+Health+Study&rft.volume=63&rft.issue=4&rft.pages=565-72&rft.date=2011&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3427008%23id-name%3DPMC&rft_id=info%3Apmid%2F21547850&rft_id=info%3Adoi%2F10.1080%2F01635581.2011.551988&rft.aulast=Tantamango&rft.aufirst=Yessenia+M&rft.au=Knutsen%2C+Synnove+F&rft.au=Beeson%2C+W+Lawrence&rft.au=Fraser%2C+Gary&rft.au=Sabate%2C+Joan&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3427008&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-pmid20501711-22"><span class="mw-cite-backlink">^ <a href="#cite_ref-pmid20501711_22-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-pmid20501711_22-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-pmid20501711_22-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSummers2010" class="citation journal cs1">Summers, Ronald M (2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875919">"Polyp Size Measurement at CT Colonography: What Do We Know and What Do We Need to Know?"</a>. <i>Radiology</i>. <b>255</b> (3): 707–20. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1148%2Fradiol.10090877">10.1148/radiol.10090877</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875919">2875919</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20501711">20501711</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Radiology&rft.atitle=Polyp+Size+Measurement+at+CT+Colonography%3A+What+Do+We+Know+and+What+Do+We+Need+to+Know%3F&rft.volume=255&rft.issue=3&rft.pages=707-20&rft.date=2010&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2875919%23id-name%3DPMC&rft_id=info%3Apmid%2F20501711&rft_id=info%3Adoi%2F10.1148%2Fradiol.10090877&rft.aulast=Summers&rft.aufirst=Ronald+M&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2875919&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> <li id="cite_note-23"><span class="mw-cite-backlink"><b><a href="#cite_ref-23">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLuis_Bujanda_Fernández_de_Piérola,_Joaquin_Cubiella_Fernández,_Fernando_Múgica_Aguinaga,_Lander_Hijona_Muruamendiaraz_and_Carol_Julyssa_Cobián_Malaver2013" class="citation book cs1">Luis Bujanda Fernández de Piérola, Joaquin Cubiella Fernández, Fernando Múgica Aguinaga, Lander Hijona Muruamendiaraz and Carol Julyssa Cobián Malaver (2013). 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Gastrointestinal+Endoscopy&rft.atitle=Recommendations+for+Follow-Up+After+Colonoscopy+and+Polypectomy%3A+A+Consensus+Update+by+the+US+Multi-Society+Task+Force+on+Colorectal+Cancer&rft.volume=91&rft.issue=3&rft.pages=463-485.e5&rft.date=2020&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7389642%23id-name%3DPMC&rft.issn=0016-5107&rft_id=info%3Apmid%2F32044106&rft_id=info%3Adoi%2F10.1016%2Fj.gie.2020.01.014&rft.aulast=Gupta&rft.aufirst=Samir&rft.au=Lieberman%2C+David&rft.au=Anderson%2C+Joseph+C.&rft.au=Burke%2C+Carol+A.&rft.au=Dominitz%2C+Jason+A.&rft.au=Kaltenbach%2C+Tonya&rft.au=Robertson%2C+Douglas+J.&rft.au=Shaukat%2C+Aasma&rft.au=Syngal%2C+Sapna&rft.au=Rex%2C+Douglas+K.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7389642&rfr_id=info%3Asid%2Fen.wikipedia.org%3AColorectal+polyp" class="Z3988"></span></span> </li> </ol></div></div> <div 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dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1209892" class="extiw" title="d:Q1209892">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/K63.5">K63.5</a> & various</li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D003111">D003111</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000266.htm">000266</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/414-overview">med/414</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Digestive_system_neoplasia" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digestive_system_neoplasia" title="Template:Digestive system neoplasia"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digestive_system_neoplasia" title="Template talk:Digestive system neoplasia"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digestive_system_neoplasia" title="Special:EditPage/Template:Digestive system neoplasia"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Digestive_system_neoplasia" style="font-size:114%;margin:0 4em"><a href="/wiki/Digestive_system_neoplasm" title="Digestive system neoplasm">Digestive system neoplasia</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Upper_alimentary_tract#Upper_gastrointestinal_tract" class="mw-redirect" title="Upper alimentary tract">Upper</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Esophageal_cancer" title="Esophageal cancer">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Squamous_cell_carcinoma" class="mw-redirect" title="Squamous cell carcinoma">Squamous cell carcinoma</a></li> <li><a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stomach_cancer" title="Stomach cancer">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastric_carcinoma" class="mw-redirect" title="Gastric carcinoma">Gastric carcinoma</a></li> <li><a href="/wiki/Signet_ring_cell_carcinoma" title="Signet ring cell carcinoma">Signet ring cell carcinoma</a></li> <li><a href="/wiki/Gastric_lymphoma" title="Gastric lymphoma">Gastric lymphoma</a> <ul><li><a href="/wiki/MALT_lymphoma" title="MALT lymphoma">MALT lymphoma</a></li></ul></li> <li><a href="/wiki/Linitis_plastica" title="Linitis plastica">Linitis plastica</a></li> <li><a href="/wiki/Hereditary_diffuse_gastric_cancer" title="Hereditary diffuse gastric cancer">Hereditary diffuse gastric cancer</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract#Lower_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Lower</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine_cancer" title="Small intestine cancer">Small intestine</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Duodenal_cancer" title="Duodenal cancer">Duodenal cancer</a> <ul><li><a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Appendix_cancer" title="Appendix cancer">Appendix</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carcinoid" title="Carcinoid">Carcinoid</a></li> <li><a href="/wiki/Pseudomyxoma_peritonei" title="Pseudomyxoma peritonei">Pseudomyxoma peritonei</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Colorectal_cancer" title="Colorectal cancer">Colon/rectum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a class="mw-selflink selflink">Colorectal polyp</a>:</i> <a href="/wiki/Colorectal_adenoma" title="Colorectal adenoma">adenoma</a>, <a href="/wiki/Hyperplastic_polyp" title="Hyperplastic polyp">hyperplastic</a>, <a href="/wiki/Juvenile_polyp" title="Juvenile polyp">juvenile</a>, <a href="/wiki/Sessile_serrated_adenoma" class="mw-redirect" title="Sessile serrated adenoma">sessile serrated adenoma</a>, <a href="/wiki/Traditional_serrated_adenoma" title="Traditional serrated adenoma">traditional serrated adenoma</a>, <a href="/wiki/Peutz%E2%80%93Jeghers_syndrome" title="Peutz–Jeghers syndrome">Peutz–Jeghers</a>, <a href="/wiki/Cronkhite%E2%80%93Canada_syndrome" title="Cronkhite–Canada syndrome">Cronkhite–Canada</a></li></ul> <ul><li><i>Polyposis syndromes:</i> <a href="/wiki/Juvenile_polyposis_syndrome" title="Juvenile polyposis syndrome">Juvenile</a></li> <li><a href="/wiki/MUTYH-associated_polyposis" title="MUTYH-associated polyposis">MUTYH-associated</a></li> <li><a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">Familial adenomatous</a>/<a href="/wiki/Gardner%27s_syndrome" title="Gardner's syndrome">Gardner's</a></li> <li><a href="/wiki/Polymerase_proofreading-associated_polyposis" title="Polymerase proofreading-associated polyposis">Polymerase proofreading-associated</a></li> <li><a href="/wiki/Serrated_polyposis_syndrome" title="Serrated polyposis syndrome">Serrated polyposis</a></li></ul> <ul><li><i>Neoplasm:</i> <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li> <li><a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">Familial adenomatous polyposis</a></li> <li><a href="/wiki/Hereditary_nonpolyposis_colorectal_cancer" title="Hereditary nonpolyposis colorectal cancer">Hereditary nonpolyposis colorectal cancer</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_cancer" title="Anal cancer">Anus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Squamous_cell_carcinoma" class="mw-redirect" title="Squamous cell carcinoma">Squamous cell carcinoma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Upper and/or lower</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastrointestinal_stromal_tumor" title="Gastrointestinal stromal tumor">Gastrointestinal stromal tumor</a></li> <li><a href="/wiki/Krukenberg_tumor" title="Krukenberg tumor">Krukenberg tumor (metastatic)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_tumor" title="Liver tumor">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Malignant" class="mw-redirect" title="Malignant">malignant</a>:</i> <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a> <ul><li><a href="/wiki/Fibrolamellar_hepatocellular_carcinoma" title="Fibrolamellar hepatocellular carcinoma">Fibrolamellar</a></li></ul></li> <li><a href="/wiki/Hepatoblastoma" title="Hepatoblastoma">Hepatoblastoma</a></li> <li><a href="/wiki/Liver_angiosarcoma" title="Liver angiosarcoma">Liver angiosarcoma</a></li></ul> <ul><li><i><a href="/wiki/Benign_tumor" title="Benign tumor">benign</a>:</i> <a href="/wiki/Hepatocellular_adenoma" title="Hepatocellular adenoma">Hepatocellular adenoma</a></li> <li><a href="/wiki/Cavernous_hemangioma" title="Cavernous hemangioma">Cavernous hemangioma</a></li></ul> <ul><li><i><a href="/wiki/Hyperplasia" title="Hyperplasia">hyperplasia</a>:</i> <a href="/wiki/Focal_nodular_hyperplasia" title="Focal nodular hyperplasia">Focal nodular hyperplasia</a></li> <li><a href="/wiki/Nodular_regenerative_hyperplasia" title="Nodular regenerative hyperplasia">Nodular regenerative hyperplasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Biliary_tract" title="Biliary tract">Biliary tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Bile_duct" title="Bile duct">bile duct</a>:</i> <a href="/wiki/Cholangiocarcinoma" title="Cholangiocarcinoma">Cholangiocarcinoma</a></li> <li><a href="/wiki/Klatskin_tumor" title="Klatskin tumor">Klatskin tumor</a></li></ul> <ul><li><i><a href="/wiki/Gallbladder" title="Gallbladder">gallbladder</a>:</i> <a href="/wiki/Gallbladder_cancer" title="Gallbladder cancer">Gallbladder cancer</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatic_cancer" title="Pancreatic cancer">Pancreas</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Exocrine_pancreas" class="mw-redirect" title="Exocrine pancreas">exocrine pancreas</a>:</i> <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li> <li><a href="/wiki/Pancreatic_ductal_carcinoma" class="mw-redirect" title="Pancreatic ductal carcinoma">Pancreatic ductal carcinoma</a></li></ul> <ul><li><i><a href="/wiki/Cyst" title="Cyst">cystic</a> <a href="/wiki/Neoplasm" title="Neoplasm">neoplasms</a></i>: <a href="/wiki/Serous_microcystic_adenoma" class="mw-redirect" title="Serous microcystic adenoma">Serous microcystic adenoma</a></li> <li><a href="/wiki/Intraductal_papillary_mucinous_neoplasm" title="Intraductal papillary mucinous neoplasm">Intraductal papillary mucinous neoplasm</a></li> <li><a href="/wiki/Pancreatic_mucinous_cystic_neoplasm" title="Pancreatic mucinous cystic neoplasm">Mucinous cystic neoplasm</a></li> <li><a href="/wiki/Solid_pseudopapillary_neoplasm" class="mw-redirect" title="Solid pseudopapillary neoplasm">Solid pseudopapillary neoplasm</a></li></ul> <ul><li><a href="/wiki/Pancreatoblastoma" title="Pancreatoblastoma">Pancreatoblastoma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneum" title="Peritoneum">Peritoneum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Primary_peritoneal_carcinoma" title="Primary peritoneal carcinoma">Primary peritoneal carcinoma</a></li> <li><a href="/wiki/Peritoneal_mesothelioma" title="Peritoneal mesothelioma">Peritoneal mesothelioma</a></li> <li><a href="/wiki/Desmoplastic_small_round_cell_tumor" class="mw-redirect" title="Desmoplastic small round cell tumor">Desmoplastic small round cell tumor</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox authority-control" aria-label="Navbox" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a>: National <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q1209892#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85067570">United States</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" 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