| Juvenile polyp | |
|---|---|
| Other names | Retention polyp [1] |
| Specialty | Gastroenterology |
| Symptoms |
Asymptomatic Rectal bleeding Rectal prolapse |
| Usual onset | Childhood |
| Types | Solitary Juvenile polyposis syndrome |
| Diagnostic method | Colonoscopy |
| Differential diagnosis |
Hyperplastic polyp, Inflammatory polyp,
Cowden syndrome Peutz-Jeghers syndrome |
| Treatment | Polypectomy |
| Frequency | 2% of children |
Juvenile polyps are a type of polyp found in the colon. While juvenile polyps are typically found in children, they may be found in people of any age. Juvenile polyps are a type of hamartomatous polyps, which consist of a disorganized mass of tissue. They occur in about two percent of children. [2] Juvenile polyps often do not cause symptoms (asymptomatic); when present, symptoms usually include gastrointestinal bleeding and prolapse through the rectum. Removal of the polyp ( polypectomy) is warranted when symptoms are present, for treatment and definite histopathological diagnosis. In the absence of symptoms, removal is not necessary. Recurrence of polyps following removal is relatively common. [3] Juvenile polyps are usually sporadic, occurring in isolation, although they may occur as a part of juvenile polyposis syndrome. Sporadic juvenile polyps may occur in any part of the colon, but are usually found in the distal colon ( rectum and sigmoid). In contrast to other types of colon polyps, juvenile polyps are not premalignant and are not usually associated with a higher risk of cancer; [4] however, individuals with juvenile polyposis syndrome are at increased risk of gastric and colorectal cancer. [2] [5] Unlike juvenile polyposis syndrome, solitary juvenile polyps do not require follow up with surveillance colonoscopy.
Signs and symptoms
Juvenile polyps often do not cause symptoms (asymptomatic); when present, symptoms usually include gastrointestinal bleeding and prolapse through the rectum. Juvenile polyps are usually sporadic, occurring in isolation, although they may occur as a part of juvenile polyposis syndrome. Sporadic juvenile polyps may occur in any part of the colon, but are usually found in the distal colon ( rectum and sigmoid). [6]
Histopathology
Under microscopy, juvenile polyps are characterized by cystic architecture, mucus-filled glands, and prominent lamina propria. Inflammatory cells may be present. Compared with sporadic polyps, polyps that occur in juvenile polyposis syndrome tend to have more of a frond-like (resembling a leaf) growth pattern with fewer stroma, fewer dilated glands and smaller glands with more proliferation. [2] Syndrome-related juvenile polyps also demonstrate more neoplasia and increased COX-2 expression compared with sporadic juvenile polyps. [2]
Diagnosis
Juvenile polyps are diagnosed by examination of their distinctive histopathology, generally after polypectomy via endoscopy. [7] Juvenile polyps cause fecal calprotectin level to be elevated. [8]
Treatment
If symptoms are present, then removal of the polyp (polypectomy) is warranted. Recurrence of polyps following removal is relatively common. [3] Unlike juvenile polyposis syndrome, solitary juvenile polyps do not require follow up with surveillance colonoscopy. [7]
Epidemiology
Juvenile polyps occur in about 2 percent of children. [2] In contrast to other types of colon polyps, juvenile polyps are not premalignant and are not usually associated with a higher risk of cancer; [4] however, individuals with juvenile polyposis syndrome are at increased risk of gastric and colorectal cancer. [2] [5]
References
- ^ Popović M, Knežević A, Škopelja JD, Đolai M (2022). "JUVENILE POLYP IN ADULTS". Acta Clinica Croatia. 61 (2): 354–358. doi: 10.20471/acc.2022.61.02.23. PMC 9934046. PMID 36818922.
- ^ a b c d e f Brosens, LA; Langeveld, D; van Hattem, WA; Giardiello, FM; Offerhaus, GJ (28 November 2011). "Juvenile polyposis syndrome". World Journal of Gastroenterology. 17 (44): 4839–44. doi: 10.3748/wjg.v17.i44.4839. PMC 3235625. PMID 22171123.
- ^ a b Fox, VL; Perros, S; Jiang, H; Goldsmith, JD (September 2010). "Juvenile polyps: recurrence in patients with multiple and solitary polyps". Clinical Gastroenterology and Hepatology. 8 (9): 795–9. doi: 10.1016/j.cgh.2010.05.010. PMID 20580940.
- ^ a b Nugent, KP; Talbot, IC; Hodgson, SV; Phillips, RK (September 1993). "Solitary juvenile polyps: not a marker for subsequent malignancy". Gastroenterology. 105 (3): 698–700. doi: 10.1016/0016-5085(93)90885-g. PMID 8395444.
- ^ a b Hood, B; Bigler, S; Bishop, P; Liu, H; Ahmad, N; Renault, M; Nowicki, M (October 2011). "Juvenile polyps and juvenile polyp syndromes in children: a clinical and endoscopic survey". Clinical Pediatrics. 50 (10): 910–5. doi: 10.1177/0009922811407177. PMID 21576185. S2CID 8295632.
- ^ "Familial Juvenile Polyposis". The Lecturio Medical Concept Library. Retrieved 22 July 2021.
- ^ a b Durno, CA (April 2007). "Colonic polyps in children and adolescents". Canadian Journal of Gastroenterology. 24 (4): 233–239. doi: 10.1155/2007/401674. PMC 2657698. PMID 17431512.
- ^ Olafsdottir, I; Nemeth, A; Lörinc, E; Toth, E; Agardh, D (January 2016). "Value of Fecal Calprotectin as a Biomarker for Juvenile Polyps in Children Investigated With Colonoscopy". Journal of Pediatric Gastroenterology and Nutrition. 62 (1): 43–6. doi: 10.1097/MPG.0000000000000893. PMID 26147630. S2CID 19284840.
| Juvenile polyp | |
|---|---|
| Other names | Retention polyp [1] |
| Specialty | Gastroenterology |
| Symptoms |
Asymptomatic Rectal bleeding Rectal prolapse |
| Usual onset | Childhood |
| Types | Solitary Juvenile polyposis syndrome |
| Diagnostic method | Colonoscopy |
| Differential diagnosis |
Hyperplastic polyp, Inflammatory polyp,
Cowden syndrome Peutz-Jeghers syndrome |
| Treatment | Polypectomy |
| Frequency | 2% of children |
Juvenile polyps are a type of polyp found in the colon. While juvenile polyps are typically found in children, they may be found in people of any age. Juvenile polyps are a type of hamartomatous polyps, which consist of a disorganized mass of tissue. They occur in about two percent of children. [2] Juvenile polyps often do not cause symptoms (asymptomatic); when present, symptoms usually include gastrointestinal bleeding and prolapse through the rectum. Removal of the polyp ( polypectomy) is warranted when symptoms are present, for treatment and definite histopathological diagnosis. In the absence of symptoms, removal is not necessary. Recurrence of polyps following removal is relatively common. [3] Juvenile polyps are usually sporadic, occurring in isolation, although they may occur as a part of juvenile polyposis syndrome. Sporadic juvenile polyps may occur in any part of the colon, but are usually found in the distal colon ( rectum and sigmoid). In contrast to other types of colon polyps, juvenile polyps are not premalignant and are not usually associated with a higher risk of cancer; [4] however, individuals with juvenile polyposis syndrome are at increased risk of gastric and colorectal cancer. [2] [5] Unlike juvenile polyposis syndrome, solitary juvenile polyps do not require follow up with surveillance colonoscopy.
Signs and symptoms
Juvenile polyps often do not cause symptoms (asymptomatic); when present, symptoms usually include gastrointestinal bleeding and prolapse through the rectum. Juvenile polyps are usually sporadic, occurring in isolation, although they may occur as a part of juvenile polyposis syndrome. Sporadic juvenile polyps may occur in any part of the colon, but are usually found in the distal colon ( rectum and sigmoid). [6]
Histopathology
Under microscopy, juvenile polyps are characterized by cystic architecture, mucus-filled glands, and prominent lamina propria. Inflammatory cells may be present. Compared with sporadic polyps, polyps that occur in juvenile polyposis syndrome tend to have more of a frond-like (resembling a leaf) growth pattern with fewer stroma, fewer dilated glands and smaller glands with more proliferation. [2] Syndrome-related juvenile polyps also demonstrate more neoplasia and increased COX-2 expression compared with sporadic juvenile polyps. [2]
Diagnosis
Juvenile polyps are diagnosed by examination of their distinctive histopathology, generally after polypectomy via endoscopy. [7] Juvenile polyps cause fecal calprotectin level to be elevated. [8]
Treatment
If symptoms are present, then removal of the polyp (polypectomy) is warranted. Recurrence of polyps following removal is relatively common. [3] Unlike juvenile polyposis syndrome, solitary juvenile polyps do not require follow up with surveillance colonoscopy. [7]
Epidemiology
Juvenile polyps occur in about 2 percent of children. [2] In contrast to other types of colon polyps, juvenile polyps are not premalignant and are not usually associated with a higher risk of cancer; [4] however, individuals with juvenile polyposis syndrome are at increased risk of gastric and colorectal cancer. [2] [5]
References
- ^ Popović M, Knežević A, Škopelja JD, Đolai M (2022). "JUVENILE POLYP IN ADULTS". Acta Clinica Croatia. 61 (2): 354–358. doi: 10.20471/acc.2022.61.02.23. PMC 9934046. PMID 36818922.
- ^ a b c d e f Brosens, LA; Langeveld, D; van Hattem, WA; Giardiello, FM; Offerhaus, GJ (28 November 2011). "Juvenile polyposis syndrome". World Journal of Gastroenterology. 17 (44): 4839–44. doi: 10.3748/wjg.v17.i44.4839. PMC 3235625. PMID 22171123.
- ^ a b Fox, VL; Perros, S; Jiang, H; Goldsmith, JD (September 2010). "Juvenile polyps: recurrence in patients with multiple and solitary polyps". Clinical Gastroenterology and Hepatology. 8 (9): 795–9. doi: 10.1016/j.cgh.2010.05.010. PMID 20580940.
- ^ a b Nugent, KP; Talbot, IC; Hodgson, SV; Phillips, RK (September 1993). "Solitary juvenile polyps: not a marker for subsequent malignancy". Gastroenterology. 105 (3): 698–700. doi: 10.1016/0016-5085(93)90885-g. PMID 8395444.
- ^ a b Hood, B; Bigler, S; Bishop, P; Liu, H; Ahmad, N; Renault, M; Nowicki, M (October 2011). "Juvenile polyps and juvenile polyp syndromes in children: a clinical and endoscopic survey". Clinical Pediatrics. 50 (10): 910–5. doi: 10.1177/0009922811407177. PMID 21576185. S2CID 8295632.
- ^ "Familial Juvenile Polyposis". The Lecturio Medical Concept Library. Retrieved 22 July 2021.
- ^ a b Durno, CA (April 2007). "Colonic polyps in children and adolescents". Canadian Journal of Gastroenterology. 24 (4): 233–239. doi: 10.1155/2007/401674. PMC 2657698. PMID 17431512.
- ^ Olafsdottir, I; Nemeth, A; Lörinc, E; Toth, E; Agardh, D (January 2016). "Value of Fecal Calprotectin as a Biomarker for Juvenile Polyps in Children Investigated With Colonoscopy". Journal of Pediatric Gastroenterology and Nutrition. 62 (1): 43–6. doi: 10.1097/MPG.0000000000000893. PMID 26147630. S2CID 19284840.