Juvenile polyposis (coli)--high incidence of dysplastic epithelium.

BACKGROUND

A juvenile polyp is a commonly seen condition in the pediatric age group as an etiological factor for rectal bleeding. The histological appearance was considered to be nonneoplastic and was distinguished from other neoplastic polyps. But this concept has been changing over the years as higher incidence of colonic and rectal adenocarcinomas are seen in patients with both familial and nonfamilial polyposis. The malignant potential was first recognized in 1980.

METHODS

With this background knowledge, the authors carried out a retrospective study of juvenile polyposis patients, who underwent full-length colonoscopy and upper gastrointestinal endoscopy to assess the presence of dysplastic epithelium. There were eleven cases of nonfamilial juvenile polyposis (one case with foregut polyps).

RESULTS

Ten cases showed presence of dysplastic epithelium in focal areas in the juvenile polyps, mild in degree in three cases and moderate in degree in 10 cases, with focal severe degree in two.

CONCLUSION

All polyps of juvenile polyposis after polypectomy must be subjected to histopathologic examination to determine the presence of dysplastic/adenomatous epithelium.