Tubular adenoma with dysplasia of 1-2 degrees

Pathologies of the intestine are found in many people. A particularly dangerous disease of this organ is malignant degeneration of the epithelium. Cancer of the colon and rectum occupies one of the leading places in the oncological structure of pathologies. This disease often leads to death of patients. Therefore, it is important to detect in time those conditions that precede malignant growth of cells. One such pathology is the tubular adenoma (polyp). Despite the fact that it consists of normal epithelial cells, it can degenerate into a tumor. Therefore, if an adenoma of the intestine is detected, it is always necessary to consult an oncologist. In most cases, it is necessary to remove the formation surgically.

What is tubular adenoma of the colon?

Benign intestinal neoplasms are often found. In rare cases, they bring inconvenience and make themselves felt. More often their presence is found out by chance, during preventive examination or during treatment of other pathologies of the digestive tract. One such neoplasm is tubular adenoma of the intestine. Outwardly it is a small growth on the inner surface of the epithelium. If you take a small piece of adenoma tissue (hold a biopsy) and examine it under a microscope, you can see the mature cells of the intestine. As with all benign neoplasms, the histological structure of this growth completely repeats the structure of the epithelium. Nevertheless, tubular adenoma is a disease, against which often develops colorectal cancer. Therefore, it poses a danger to the health of the patient. Another name for this benign neoplasm is the polypoid adenoma. It occurs in about 5% of the population. The frequency of adenoma does not depend on the age and sex of the person. In some cases, there are multiple polyps. It is believed that in the presence of a single tubular adenoma of a small size, the risk of malignancy is low. Nevertheless, this education is the reason for registration in the oncology dispensary for continuous monitoring.

The causes of adenoma in the intestine

Scientists have not yet determined the exact etiological factor that promotes the development of adenomas of the intestine. There are several theories of the occurrence of benign neoplasms. Most doctors believe that the combination of several factors plays a leading role in the onset of this disease. On this basis, there are several reasons for the appearance of tubular adenoma:

1. Genetic predisposition. Heredity in the occurrence of polyps of the intestine is of great importance. In some cases, tubular adenomas are detected in several family members.
2. Nature of food. It is believed that people in the diet of which a large number of animal fats, have a tendency to the appearance of both benign neoplasms and gastrointestinal cancer. In turn, the risk of these pathologies decreases with the use of vegetables, greens, food, rich in fiber.
3. Bad habits.
4. Effects on the body of various chemical agents, ionizing radiation.
5. Stressful situations.

Most often, tubular adenoma occurs in the elderly. Due to the fact that this group of people has a higher risk of developing bowel cancer, polyps are subject to mandatory removal.

Varieties of tubular adenomas

The tubular adenoma can have a different size. It ranges from a few mm to 2-3 cm. Depending on the microscopic pattern, "sessile" polyps and benign lesions on the pedicle are distinguished. Also, tubular adenomas differ in localization. They can be located in the stomach, thick and sigmoid colon. Depending on the amount of adenomas, single and multiple polyps are isolated. The most important choice for the treatment and prognosis of the disease is a classification based on the histological structure of the neoplasm tissue. Depending on this, three types of intestinal polyps are distinguished:

1. Tubular benign adenoma. With microscopic examination, one can see that polyp cells of this type are elongated or branching tubules surrounded by connective tissue.
2. Tubular-villous adenoma - develops under the influence of unfavorable factors and in the absence of treatment. The appearance of polyps of this type increases the risk of degeneration into a cancerous tumor. Histological examination reveals both tubular cells and fibrosis sites.
3. The nasal adenoma. This variety of intestinal polyps is an obligate precancerous condition, that is, it is always transformed into a malignant tumor. When removing this formation, the macro preparation resembles sea cabbage.

It is worth remembering that, despite the "harmlessness" of the tubular adenoma, it almost always transforms into a villous polyp. On average this happens 4-5 years after its discovery.

Clinical picture of tubular adenoma of the intestine

At small sizes, tubular adenoma does not have any clinical manifestations. This is due to the fact that education does not interfere with the normal functioning of the intestine and the passage of stool. If the polyp reaches a few centimeters in diameter (from 2 or more), its presence can be suspected by clinical symptoms. Among them, there are such changes as intestinal discomfort, pathological discharge, pain during defecation. Symptoms of tubular adenoma:

1. Constipation or diarrhea.
2. Appearance of blood during defecation. This is due to the fact that stools injure the wall of the tubular adenoma.
3. Pain during the bowel movement.
4. Itching in the anus.

It should be remembered that such symptoms may indicate the onset of a malignant tumor of the sigmoid or rectum. Therefore, when developing a similar clinical picture, it is necessary to urgently consult a proctologist.

Tubular adenoma of the colon with dysplasia: a description

The transition of benign education into cancer begins with a gradual change in the cellular composition of the adenoma - dysplasia. In the tubular polyp this process is not observed. Often, cellular rearrangement takes place with the villous formations. Nevertheless, such a concept as tubular adenoma with dysplasia exists. The appearance of immature cells often occurs when the polyp is enlarged in size. The tubular adenoma is transformed into a tubular-villous formation. Dysplasia does not always indicate malignancy of the process. It depends on the degree of maturity of adenoma cells. Nevertheless, the appearance of undifferentiated elements, even in a minimal amount, increases the risk of developing a cancer of the intestine.

Degrees of dysplasia in tubular adenomas

There are 3 degrees of dysplasia in tubular adenomas of the intestine. The tactics of the doctor depends on how much the cells of the polyp have changed. Tubular adenoma with dysplasia of 1-2 degrees has a favorable prognosis for treatment. A high probability of degeneration into cancer is observed with pronounced changes in the cellular composition of the polyp. Moderate dysplasia is characterized by a thickening of the basal layer of the intestinal epithelium. The cell nucleus is hypochromic, the number of mitoses is increased. Dysplasia of the middle degree differs in that the basal layer of the epithelium is blurred, pronounced proliferation in the germ cell zone is observed. In addition, the elements themselves differ in size and shape. The expressed degree of dysplasia is the terminal stage, followed by atypia. The cells are distinguished by hyperchromy and polymorphism. The number of modified elements is from 0.5 to 1% of the epithelial tissue.

Diagnosis of tubular adenoma of the intestine

If there is a suspicion of tubular adenoma, endoscopic examinations are performed . They include colonoscopy and sigmoidoscopy. The choice of method depends on the localization of the polyp in the intestine. The decisive role in diagnostics is given to histological and cytological research.

Treatment for tubular adenoma

The main method of treatment is surgical removal of the polyp. In rare cases, the tubular adenoma is simply observed (with small dimensions). In this case, the patient must follow a diet and eliminate bad habits. Often carried out endoscopic polypectomy. With severe dysplasia perform the operation.

Prevention of the appearance of tubular adenomas

It is impossible to predict the development of tubular adenoma. Nevertheless, preventive measures include proper nutrition (predominance in the diet of fiber, a small amount of fat). It should also be excluded from smoking and drinking alcohol with a hereditary anamnesis. After 60 years, it is recommended to perform a diagnostic colonoscopy.