Department of Colorectal Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Ir J Med Sci. 2011 Mar;180(1):269-70. doi: 10.1007/s11845-009-0422-5. Epub 2009 Sep 26.
Hyperplastic polyposis (HP) is important to recognise as it increases the risk of adenomata which may develop dysplastic change or frank adenocarcinoma. We present the case of a 58-year-old woman with HP.
Following a diagnosis of HP in this patient, it was noted that the number of polyps were progressively increasing over time, becoming pancolic and extending into the rectum. Genetic testing for a familial polypotic syndrome was negative. Histological analysis demonstrated that the majority of polyps were hyperplastic, but there were also serrated and tubular adenomata with foci of low-grade dysplasia. Whilst there was no evidence of frank malignancy or high-grade dysplasia, following a risk-benefit discussion the patient underwent a laparoscopic total colectomy with an ileal pouch formation.
This case highlights the complexity in the management of HP and that even in the absence of confirmed invasive disease, patients may elect to undergo prophylactic colonic resection.
增生性息肉（HP）需要被识别，因为它会增加腺瘤的风险，而腺瘤可能会发生异型增生或腺癌。我们报告一例 58 岁的 HP 患者。
该患者被诊断为 HP 后，发现息肉数量随时间逐渐增加，累及全结肠并延伸至直肠。家族性息肉病综合征的基因检测结果为阴性。组织学分析显示，大多数息肉为增生性，但也有锯齿状和管状腺瘤，伴有局灶性低级别异型增生。尽管没有证据表明存在恶性肿瘤或高级别异型增生，但在进行风险获益讨论后，患者接受了腹腔镜全结肠切除术和回肠袋形成术。
本病例强调了 HP 管理的复杂性，即使没有明确的侵袭性疾病证据，患者也可能选择进行预防性结肠切除术。
