Colon polyps classification: Difference between revisions

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==Overview==
==Overview==
There is no established system for the classification of [disease name].
Colon polyps may be classified into two groups of [[Cancer|neoplastic]] and non-neoplastic. Non-neoplastic polyps consist of [[Inflammation|inflammatory]] and [[Hamartoma|hamartomatous]] polyps. [[Cancer|Neoplastic]] polyps consist of serrated and [[Villous adenoma|adenomatous polyps]]. [[Villous adenoma|Adenomatous polyps]] may be classified into several subtypes based on [[Endoscopy|endoscopic]] and [[Histology|histologic]] features, and degree of [[dysplasia]]. [[Adenoma|Adenomas]] may be classified according to [[Endoscopy|endoscopic]] features into four groups including [[sessile]], [[pedunculated]], flat, or depressed. [[Adenoma|Adenomas]] may be classified according to [[Histology|histologic]] features into three groups including tubular, tubulovillous, and [[Villous adenoma|villous]].  
 
OR
 
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
 
OR
 
[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
[Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
 
OR
 
Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
 
OR
 
If the staging system involves specific and characteristic findings and features:
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
 
OR
 
The staging of [malignancy name] is based on the [staging system].
 
OR
 
There is no established system for the staging of [malignancy name].


==Classification==
==Classification==
*Colon polyps may be classified into two groups:  
*Colon polyps may be classified into several subtypes based on:<ref name="ShussmanWexner2014">{{cite journal|last1=Shussman|first1=N.|last2=Wexner|first2=S. D.|title=Colorectal polyps and polyposis syndromes|journal=Gastroenterology Report|volume=2|issue=1|year=2014|pages=1–15|issn=2052-0034|doi=10.1093/gastro/got041}}</ref><ref name="pmid17516746">{{cite journal |vauthors=Li SC, Burgart L |title=Histopathology of serrated adenoma, its variants, and differentiation from conventional adenomatous and hyperplastic polyps |journal=Arch. Pathol. Lab. Med. |volume=131 |issue=3 |pages=440–5 |year=2007 |pmid=17516746 |doi=10.1043/1543-2165(2007)131[440:HOSAIV]2.0.CO;2 |url=}}</ref><ref name="Bonnington2016">{{cite journal|last1=Bonnington|first1=Stewart N|title=Surveillance of colonic polyps: Are we getting it right?|journal=World Journal of Gastroenterology|volume=22|issue=6|year=2016|pages=1925|issn=1007-9327|doi=10.3748/wjg.v22.i6.1925}}</ref><ref name="PonugotiLin2017">{{cite journal|last1=Ponugoti|first1=Prasanna|last2=Lin|first2=Jingmei|last3=Odze|first3=Robert|last4=Snover|first4=Dale|last5=Kahi|first5=Charles|last6=Rex|first6=Douglas K.|title=Prevalence of sessile serrated adenoma/polyp in hyperplastic-appearing diminutive rectosigmoid polyps|journal=Gastrointestinal Endoscopy|volume=85|issue=3|year=2017|pages=622–627|issn=00165107|doi=10.1016/j.gie.2016.10.022}}</ref><ref name="O'Brien2007">{{cite journal|last1=O'Brien|first1=Michael J.|title=Hyperplastic and Serrated Polyps of the Colorectum|journal=Gastroenterology Clinics of North America|volume=36|issue=4|year=2007|pages=947–968|issn=08898553|doi=10.1016/j.gtc.2007.08.007}}</ref>
**Neoplastic
** [[Cancer|Malignancy]] potentials
**Non-neoplastic
** [[Endoscopy|Endoscopic]] features
Non-neoplastic polyps may be classified into 4 subtypes:  
** [[Histology|Histologic]] features
*Inflammatory polyps
** Degree of [[dysplasia]]
**Inflammatory pseudopolyps
'''Colon polyps may be classified according to the NBI International Colorectal Endoscopic (NICE) classification into two types:<ref name="HewettKaltenbach2012">{{cite journal|last1=Hewett|first1=David G.|last2=Kaltenbach|first2=Tonya|last3=Sano|first3=Yasushi|last4=Tanaka|first4=Shinji|last5=Saunders|first5=Brian P.|last6=Ponchon|first6=Thierry|last7=Soetikno|first7=Roy|last8=Rex|first8=Douglas K.|title=Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging|journal=Gastroenterology|volume=143|issue=3|year=2012|pages=599–607.e1|issn=00165085|doi=10.1053/j.gastro.2012.05.006}}</ref><ref name="RameshshankerWilson2016">{{cite journal|last1=Rameshshanker|first1=R.|last2=Wilson|first2=Ana|title=Electronic Imaging in Colonoscopy: Clinical Applications and Future Prospects|journal=Current Treatment Options in Gastroenterology|volume=14|issue=1|year=2016|pages=140–151|issn=1092-8472|doi=10.1007/s11938-016-0075-1}}</ref>'''
**Prolapse type inflammatory polyps
{| class="wikitable"
**Myoglandular polyps
!NICE criterion
*Hamartomatous polyps
!Type 1
**Juvenile polyps
!Type 2
**Peutz-Jeghers polyps
|-
**Cronkhite-Canada syndrome
|Color
**Phosphatase and tensin homolog (PTEN) hamartoma tumor syndrome
|Same or lighter background
*Serrated polyps
|Darker background
**Hyperplastic polyps
|-
**Traditional serrated adenomas
|[[Blood vessel|Vessels]]
**Sessile serrated polyps
|None, or isolated lacy [[Blood vessel|vessels]] coursing across the [[lesion]]
**Serrated polyposis syndrome
|Brown [[Blood vessel|vessels]] surrounding the white center
*Adenomatous polyps
|-
Adenomatous polyps may be classified into several subtypes based on:
|Surface
* Endoscopic features
|Circular pattern with dark or white small spots surrounded by lighter mucosa
* Histologic features
|Oval, tubular, or branched white structures
* degree of dysplasia
|-
Adenomas may be classified according to endoscopic features into four groups:
|Probable [[pathology]]
*Sessile
|[[Hyperplasia|Hyperplastic]]
*Pedunculated
|[[Adenoma]]
|}
'''Colon polyps may be classified according to [[Cancer|malignancy]] potentials into two large groups:'''
*Non-neoplastic
**[[Inflammation|Inflammatory]] polyps
***[[Inflammation|Inflammatory]] [[Pseudopolyp|pseudopolyps]]
***[[Prolapse]] type [[Inflammation|inflammatory]] polyps
***Myoglandular polyps
**[[Hamartoma|Hamartomatous]] polyps
***Juvenile polyps
***[[Peutz-Jeghers syndrome]]
***Cronkhite-Canada syndrome
***Phosphatase and tensin homolog (PTEN) hamartoma tumor syndrome
*[[Cancer|Neoplastic]]
**Serrated polyps
***[[Hyperplasia|Hyperplastic]] polyps
***Traditional serrated adenomas
***[[Sessile]] serrated polyps
***Serrated polyposis syndrome
**[[Villous adenoma|Adenomatous polyps]]
'''[[Adenoma|Adenomas]] may be classified according to [[Endoscopy|endoscopic]] features into four groups:'''
*[[Sessile]]
*[[Pedunculated]]
*Flat
*Flat
*Depressed
*Depressed
Adenomas may be classified according to histologic features into three groups:
'''[[Adenoma|Adenomas]] may be classified according to [[Histology|histologic]] features into three groups:'''
* Tubular
* Tubular
* Villous
* Villous
* Tubulovillous
* Tubulovillous
Adenomas may be classified according to degree of dysplasia into two groups:
'''[[Adenoma|Adenomas]] may be classified according to degree of [[dysplasia]] into two groups:'''
* Low-grade dysplasia
* Low-grade [[dysplasia]]
* High-grade dysplasia
* High-grade [[dysplasia]]
 
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
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{{WS}}
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[[Category: (name of the system)]]
 
[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]

Latest revision as of 21:00, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Colon polyps may be classified into two groups of neoplastic and non-neoplastic. Non-neoplastic polyps consist of inflammatory and hamartomatous polyps. Neoplastic polyps consist of serrated and adenomatous polyps. Adenomatous polyps may be classified into several subtypes based on endoscopic and histologic features, and degree of dysplasia. Adenomas may be classified according to endoscopic features into four groups including sessile, pedunculated, flat, or depressed. Adenomas may be classified according to histologic features into three groups including tubular, tubulovillous, and villous.

Classification

Colon polyps may be classified according to the NBI International Colorectal Endoscopic (NICE) classification into two types:[6][7]

NICE criterion Type 1 Type 2
Color Same or lighter background Darker background
Vessels None, or isolated lacy vessels coursing across the lesion Brown vessels surrounding the white center
Surface Circular pattern with dark or white small spots surrounded by lighter mucosa Oval, tubular, or branched white structures
Probable pathology Hyperplastic Adenoma

Colon polyps may be classified according to malignancy potentials into two large groups:

Adenomas may be classified according to endoscopic features into four groups:

Adenomas may be classified according to histologic features into three groups:

  • Tubular
  • Villous
  • Tubulovillous

Adenomas may be classified according to degree of dysplasia into two groups:

References

  1. ↑ Shussman, N.; Wexner, S. D. (2014). "Colorectal polyps and polyposis syndromes". Gastroenterology Report. 2 (1): 1–15. doi:10.1093/gastro/got041. ISSN 2052-0034.
  2. ↑ Li SC, Burgart L (2007). "Histopathology of serrated adenoma, its variants, and differentiation from conventional adenomatous and hyperplastic polyps". Arch. Pathol. Lab. Med. 131 (3): 440–5. doi:10.1043/1543-2165(2007)131[440:HOSAIV]2.0.CO;2. PMID 17516746.
  3. ↑ Bonnington, Stewart N (2016). "Surveillance of colonic polyps: Are we getting it right?". World Journal of Gastroenterology. 22 (6): 1925. doi:10.3748/wjg.v22.i6.1925. ISSN 1007-9327.
  4. ↑ Ponugoti, Prasanna; Lin, Jingmei; Odze, Robert; Snover, Dale; Kahi, Charles; Rex, Douglas K. (2017). "Prevalence of sessile serrated adenoma/polyp in hyperplastic-appearing diminutive rectosigmoid polyps". Gastrointestinal Endoscopy. 85 (3): 622–627. doi:10.1016/j.gie.2016.10.022. ISSN 0016-5107.
  5. ↑ O'Brien, Michael J. (2007). "Hyperplastic and Serrated Polyps of the Colorectum". Gastroenterology Clinics of North America. 36 (4): 947–968. doi:10.1016/j.gtc.2007.08.007. ISSN 0889-8553.
  6. ↑ Hewett, David G.; Kaltenbach, Tonya; Sano, Yasushi; Tanaka, Shinji; Saunders, Brian P.; Ponchon, Thierry; Soetikno, Roy; Rex, Douglas K. (2012). "Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging". Gastroenterology. 143 (3): 599–607.e1. doi:10.1053/j.gastro.2012.05.006. ISSN 0016-5085.
  7. ↑ Rameshshanker, R.; Wilson, Ana (2016). "Electronic Imaging in Colonoscopy: Clinical Applications and Future Prospects". Current Treatment Options in Gastroenterology. 14 (1): 140–151. doi:10.1007/s11938-016-0075-1. ISSN 1092-8472.

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