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

Definition of polyp

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

Classification

Polyps are classified based on several elements:

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

Summary table

NASAL POLYPES
CAUSES	SYMPTOMS	DIAGNOSIS	THERAPY
No certain cause. Hypothesis: Allergy Asthma Cystic fibrosis Sinusitis Immunodeficiency diseases Smog and drugs	ageusia Anosmia Headache Nasal congestion Dyspnoea Facial pain Increased tearing rhinorrhoea Ocular itching Snoring	history Otorhinolaryngology visit Allergy tests Hematological tests Nasal and olfactory respiratory function test Imaging test (CT or MRI) Endoscopic tests Cystic fibrosis test	Drug therapy: corticosteroids / antihistamines / antibiotics or antifungals polypectomy Endoscopic sinus surgery
UTERINE POLYPS
CAUSES	SYMPTOMS	DIAGNOSIS	THERAPY
Uncertain cause. Hypothesis: estrogenic changes. Women during the premenopause are the most affected	Menstrual changes: dysmenorrhea menorrhagia hypermenorrhoea menstrual irregularities spotting Dyspareunia (pain during sexual intercourse)	sonohysterogram Diagnostic hysteroscopy hysterosalpingography Scratching	Drug therapy with progestins or gonadotropins (ineffective) Surgical removal by hysteroscopy Hysterectomy (removal of the uterus in the case of malignant evolution)
INTESTINAL POLYPES
CAUSES	SYMPTOMS	DIAGNOSIS	THERAPY
Unbalanced diet, rich in red meat, saturated fat and low in fiber Old age Familiarity sedentary Obesity Black race	Anemia Abdominal colics Abdominal cramps Diarrhea / Constipation Mucorrea Blood in the stool Rectal tenesmus	Colonoscopy TC Sigmoidoscopy Stool examination Opaque enema (radiological examination of the large intestine)	Polypectomy: surgical removal of the polyp by endoscopy Burn (for small polyps) Colectomy (colon removal) + Post-operative chemotherapy treatment to prevent recurrences (for malignant forms)
BUMPER POLYPSES
CAUSES	SYMPTOMS	DIAGNOSIS	THERAPY
Uncertain cause Hypothesis: smoking Exposure to polycyclic aromatic hydrocarbons, pollutants and smog Schistosomiasis	Alteration of urinary frequency hematuria pollakiuria Strangury	Physical examination Cystoscopy Biopsy Washing (or irrigation) of the bladder Search for any markers of bladder cancer Imaging tests (CT and MRI)	Trans urethral resection Surgical removal of the bladder (for malignant forms) + Post-operative chemo / radiotherapy treatment to prevent recurrences (for malignant forms)
POLYPS OF THE STOMACH
CAUSES	SYMPTOMS	DIAGNOSIS	THERAPY
Chronic inflammation of the stomach (gastritis) → hyperplastic gastric polyps Familial adenomatous polyposis (hereditary disease) Old age H. pylori infections Long-term therapy with proton pump inhibitors	Abdominal pain Abdominal tenderness to pressure Gastric bleeding Nausea and vomit	Endoscopic ultrasound (eco-biopsy) Gastric biopsy Blood analysis	No treatment (small gastric polyps can regress spontaneously) Surgical removal (for large polyps) Antibiotic treatment (triple therapy) for the treatment of polyps dependent on Helicobacter pylori