POLYP, POLYPOSES (Greek poly is a lot of + p[us] a leg; Greek poly is a lot of + p[us] a leg + - osis) — the umbrella term used for designation of the pathological educations various by origin towering over the surface of mucous membranes of bodies of digestive tract, respiratory and uric ways, a uterus. In the presence of a large number of polyps apply the term of «polyposes» though the border between the concepts «multiple polyps» and «polyposes» is conditional. According to a number of researchers, the term of «polyposes» should use when the quantity of polyps exceeds 20.
Polyps have various form and a consistence, the wide or narrow basis, a smooth, lobular or fleecy surface, diameter from several millimeters to several centimeters (tsvetn. fig. 1 — 8). The microscopic structure of a polyp depends on the nature of the process which is its cornerstone. Therefore instead of the traditional umbrella terms «polyp» and «polyposes» try to use other terms more precisely reflecting character specific patol, process. Earlier, e.g., polipovidny educations went. - kish. a path on a quantitative ratio of an epithelium and a stroma called glandular (adenomatous), ferruterous and fibrous and fibrous polyps. Further names of these educations began to reflect the nature of the process which caused them. So, allocate true epithelial tumors — adenomas (see. Adenoma ), hyperplastic (regenerator) polyps, polyps of an inflammatory origin, etc. However continue to use such traditional terms as «a juvenile polyp», «Peytts's polyp — Egersa» (see. Peyttsa — Egersa a syndrome ), placental polyp (see) and some other.
Classification of polipovidny educations can be constructed on etiol, to the principle. Distinguish tumors, disregeneratorny and hyperplastic polyps, polyps of the inflammatory and allergic nature, gamartoma (see), teratomas (see), heterotopy, placental polyp, polipovidny formations of not clear etiology.
Polyps can represent true tumors (see). Carry epithelial to their number — planocellular and transitional cell papilloma (see. Papilloma, papillomatosis ), tubular adenoma (adenomatous polyp), papillary adenoma (a fleecy tumor, a papillomatous polyp) and not epithelial tumors — fibroma (see. Fibroma, fibromatosis ), leiomyoma (see), lipoma (see), myxoma (see), angioma (see), neurofibroma, osteoma (see) etc. The last can be located under a mucous membrane, raise it and eminate in a gleam of body, macroscopically creating a picture of a polyp. Though the terms «polyp» and «polyposes» mean the high-quality nature of process, a type of a polyp, especially in an initial stage of development, can have various malignant tumors.
Hyperplastic (regenerator, metaplastic) polyps most often meet on a mucous membrane of a large intestine and a stomach. Usually it is multiple educations to dia, to 0,5 — 1,0 cm, located on the wide basis or on a leg. Microscopically they consist from extended, sometimes the cystous and expanded tubules covered by an epithelium without signs of atypia or a dysplasia. At the heart of polyps of a body and neck of uterus the focal hyperplasia of a mucous membrane of a uterus (endometria) and the channel of a neck of uterus of a dishormonal or inflammatory origin lies.
Polyps of an inflammatory or allergic origin are covered not changed or atrofichny slizistokh! a cover, sometimes with sites of an ulceration. The ground mass of a polyp is presented by a connective tissue stroma, edges can be cellular infiltration, fibrous or myxomatous with various degree. Allergic polyps of a nose belong to such polyps, polyps of phonatory bands (so-called singing small knots), the inflammatory fibrous polyp (an eosinophilic granuloma) went. - kish. a path, the focal or diffusion lymphoid hyperplasia which is obviously connected with an immune response on an inflammation or an infection. Polipovidny changes of a mucous membrane of a gut at a disease have an inflammatory origin Krone, hron, ulcer colitis, dysentery.
Teratomas, gamartoma, a heterotopy can have an appearance of polyps. The teratoma similar to a hairy polyp meets on a mucous membrane of a nose, a throat, a mouth. The juvenile polyp which is considered as hectare-martomu of a stroma of a mucous membrane more often happens multiple, has a smooth surface (unlike adenoma), microscopically consists of the epithelial tubules divided by wide layers of a stroma. Epithelial tubules are covered by cylindrical or cubic cells, are often stretched and muciferous. The juvenile polyp is often combined with other malformations.
Peytts's polyps — Egersa, are more often multiple (see. Peyttsa — Egersa a syndrome ), are located preferential in a proximal part of a small bowel, but it is frequent in a stomach and a large intestine. Surface of a polyp lobular. Microscopically it represents the branching tyazh and nipples covered with the epithelial cells having the structure corresponding to that body in Krom the polyp is located. In a stroma of nipples there are bunches of unstriated muscles coming from a muscular plate of a mucous membrane.
Cavernous hemangiomas (see. Hemangioma ), located under a mucous membrane and eminating in a gleam of body, can have an appearance of polyps (angiomatous polyp).
Sites of a heterotopy of tissue of pancreas, glands of a mucous membrane of a stomach and duodenum also sometimes have an appearance of a polyp. When the heterotopic site of tissue of pancreas is presented only by channels and unstriated muscles, speak about to an adenomioma (see) or myoepithelial gamartoma.
Placental polyp (see) it can be formed in a mucous membrane of a uterus as a result of incomplete abortion or after the delivery on site the neotde-flowing sites of an afterbirth, consists from vorsin chorion, sites of decidual fabric, fibrin which are exposed to the organization and act in a cavity of the uterus.
Polyps at Kronkhayt's syndrome — Canada (polyposes went. - kish. a path, combined with an alopecia, a hyperpegmentation of skin and an atrophy of nails) are located on a mucous membrane went. - kish. a path, microscopically in them find cystous expansion of the ferruterous tubules covered by the flattened epithelium and sharply expressed hypostasis of a stroma with insignificant inflammatory infiltration.
Klien, a picture of polyps is very various and in many respects depends on localization, structures, sizes, prevalence of process and the arising complications. Sometimes polyps narrow or close a gleam, napr, intestines, the nasal courses. In other cases polyps can be a bleeding point or development of inflammatory process.
In diagnosis of polyps an important role is played rentgenol., endoscopic and morfol, methods of a research.
Treatment of hl. obr. operational. Quite often for this purpose, especially at polyps of the small sizes (tsvetn. fig. 9 — 12), use the endoscopic equipment (see. Endoscopy ). Remote polyps are exposed gistol, to a research.
Forecast, as a rule, favorable. However in some cases polyps, napr, fleecy and tubular adenomas went. - kish. a path, transitional cell papillomas of uric ways, are exposed to a malignancy (see. Carcinogenesis ).
Bibliography: Clinical oncology, under the editorship of H. N. Blochina and B. E. Peterson, t. 2, page 520, M., 1979; The Guide to pathoanatomical diagnosis of tumors of the person, under the editorship of N. A. К^аевского, etc., M., 1976; Son B. C. Histological typing-of intestinal tumors, Geneva, Could 1976; Morson B. C. a. Dawson I. M. P. Gastrointestinal pathology, Oxford, 1979; O o t a K. Histological typing of gastric and oesophageal tumors, Geneva, 1977; S h a n m u g a r a-t n a m K. Histological typing of upper respiratory tract tumors, Geneva, 1978.
V. I. Rotenberg, V. A. Romanov (color. fig. 1 — 12).