Pathology Reports: Is Your Colon Polyp Benign or Malignant?

Pathology report issues regarding colorectal polyps?

Hello Doctor: Two weeks ago, I underwent a colonoscopy with polypectomy.
The pathological report is as follows: Pathological diagnosis: Large intestine, sigmoid colon, 30 cm from anal verge, cold snare polypectomy --- Tubular adenoma with low-grade dysplasia (ICD-O-3: 8211/0).
Description: Gross: The specimen consists of three pieces of gray-white soft tissue, labeled sigmoid colon, 30 cm from anal verge, measuring up to 0.5 x 0.4 x 0.1 cm.
The specimen is embedded entirely in one block for section.
Microscopy: The sections of the specimen show colonic mucosal tissue with atypical glands, containing pseudostratified epithelium showing nuclear abnormalities and in tubular arrangement.
I would like to ask, is this polyp benign? Is there any risk of cancer development? How long should I wait before undergoing another colonoscopy? Thank you for your response, Doctor.

YO, 40~49 year old female. Ask Date: 2023/11/20

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is still benign, and you can discuss follow-up options with your physician (there may be some variations in recommendations among different physicians).

Reply Date: 2023/11/20

More Info

Based on the pathology report you provided, the diagnosis is a "tubular adenoma with low-grade dysplasia." This indicates that the polyp is indeed a benign lesion, specifically a type of neoplastic polyp. Tubular adenomas are the most common type of colorectal adenoma and are generally considered precursors to colorectal cancer, but they are not cancerous themselves.

Understanding Tubular Adenomas
1. Benign Nature: Tubular adenomas are classified as benign tumors. They do not invade surrounding tissues or metastasize like malignant tumors do. The presence of low-grade dysplasia suggests that while there are some abnormal cells, they are not indicative of cancer. Low-grade dysplasia means that the cells show some changes but are not severely abnormal.

2. Risk of Malignancy: While tubular adenomas are benign, they do carry a risk of progression to colorectal cancer, especially if they are larger or if there are multiple adenomas. The risk of cancer increases with the size of the adenoma and the degree of dysplasia. In your case, since the report indicates low-grade dysplasia, the immediate risk of cancer is low, but it is essential to monitor these lesions over time.

3. Follow-Up Colonoscopy: The timing for follow-up colonoscopy can vary based on several factors, including the size of the adenoma, the number of adenomas found, and your personal and family medical history. Generally, if a patient has a tubular adenoma with low-grade dysplasia, a follow-up colonoscopy is recommended in 5 to 10 years. However, if there are other risk factors (such as a family history of colorectal cancer or the presence of multiple adenomas), your doctor may recommend a shorter interval.

Importance of Regular Screening
Regular screening for colorectal cancer is crucial, especially if you have a history of adenomas. The American Cancer Society recommends that individuals at average risk begin screening at age 45, but those with a history of adenomas may need to start earlier or have more frequent screenings.

Conclusion
In summary, your tubular adenoma is benign, and while there is a potential risk for cancer development in the future, it is currently not malignant. It is essential to adhere to your physician's recommendations for follow-up colonoscopies to monitor for any changes. Maintaining a healthy lifestyle, including a balanced diet rich in fiber, regular exercise, and avoiding smoking and excessive alcohol consumption, can also help reduce your risk of colorectal cancer.

If you have any further questions or concerns, it is advisable to discuss them with your healthcare provider, who can provide personalized guidance based on your medical history and current health status.

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