Juvenile Polyps in the Colon and Rectum: Their Clinical Aspects and Neoplastic Potential Minoru Itsuno 1 1The Second Department of Internal Medicine, Nagasaki University School of Medicine Keyword: 若年性ポリープ , 前癌病変 , 癌化 , 潰瘍性大腸炎 pp.841-848
Published Date 1992/7/25
DOI https://doi.org/10.11477/mf.1403109922
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 Seventy four cases (79 lesions) of juvenile polyps (JP) were studied clinicopathologically. The age distribution of the patients was bimodal. The lowest incidence was in the third decade. The mean size of the polyps in the first decade patients (childhood group) was 18 mm, larger than in the older patients, in whom the average was 11 mm. Eighty four percent of colonic polyps were found on the left side of the colon. All the patients with JP in the childhood group experienced melena or prolapse of the polyps, while only 24% of the patients in the non-childhood group had these symptoms.

 Recently, there have been some reports that JP may, develop dysplastic or carcinoma. Our histological study detected one case of intramucosal carcinoma and three cases of dysplastic epithelium. These three cases of dysplastic change in JP had concominant carcinoma and/or polyps of different histological type in the different sites: 3 carcinoma in adenomas, 13 adenomas, 6 hyperplastic polyps with atypia and 5 hyperplastic polyps without atypia. Eleven hyperplastic polyps in the two cases were characterized by abundant stroma and an inflammatory cell infiltrate suggesting a pathogenetic sequence between these polyps and JP. It is clear that the epithelial cells of JP are capable of undergoing both neoplastic and kinetic changes.

 We propose that JP should not be considered as no risk for cancer, and that colonoscopic or barium enema examinations are necessary to follow up JP patients to detect malignant changes.

Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.


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