Crypt alterations and collagen deposition in hyperplastic polyps of colorectum

In order to investigate the nature of hyperplastic polyps in the colorectum, 44 longitudinally sectioned crypts from biopsied polyps were analyzed morphometrically and compared with 81 control crypts. Although the crypts in hyperplastic polyps were longer and wider, containing more cells, their cell density was less, particularly in the serrated epithelium. In these crypts, both the tall and short epithelial cells contained cytoplasmic vacuoles, even in the surface epithelium. These cells exhibited increased expression of carcinoembryonic antigen. The subepithelial collagen table was of similar thickness in the polyp and control colonic mucosa, but it extended down along the cryptal wall to a greater depth in the polyp. These and other data indicate an aberrant differentiation of cryptal epithelial cells in the polyp. On upward migration to the surface, these cells appeared to undergo an arrested maturational process. Hence, the hyperplastic polyp may be considered a disease of epithelial cell differentiation.