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Atypical hyperplastic polyps at double-contrast barium enema examination
M S Levine1, M J Barnes, M P Bronner
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Radiology
|June 1, 1990
Summary
Hyperplastic polyps often appear larger and more irregular than classic descriptions suggest. Radiologists should consider these atypical features during double-contrast barium enema examinations.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- Hyperplastic polyps are typically described as small, smooth, sessile lesions.
- Radiographic appearance can influence diagnostic accuracy.
Purpose of the Study:
- To evaluate the radiographic characteristics of pathologically proven hyperplastic polyps.
- To determine the frequency of atypical features in hyperplastic polyps on double-contrast barium enema (DCBE).
Main Methods:
- Retrospective review of 31 pathologically confirmed hyperplastic polyps from 22 patients.
- Analysis of polyp size, morphology (sessile/pedunculated), and contour (smooth/lobulated) on DCBE.
Main Results:
- Average polyp size was 7.3 mm, with 52% exceeding 5 mm.
- Lobulation (26%) and pedunculation (6%) were observed.
- 84% of polyps were located in the rectosigmoid colon.
- 52% of hyperplastic polyps met criteria for atypical features (size >5mm, lobulation, or pedunculation).
Conclusions:
- Hyperplastic polyps frequently deviate from the classic radiographic description.
- Atypical features, including larger size and lobulation, can make hyperplastic polyps indistinguishable from adenomatous polyps on DCBE.
- Radiologists must be aware of these variations for accurate polyp characterization.