Colorectal adenomas are abnormal glandular growths in the gastrointestinal tract that can turn into cancer. They can be diagnosed by colonoscopy, CT, or barium enema and are treated by removal. Adenomas can be classified by appearance and microscopic characteristics.
A colorectal adenoma is an abnormal growth of glandular tissue in the gastrointestinal tract. These growths can be diagnosed by colonoscopy, air-contrast barium enema, or computed tomography (CT). They can be classified by their appearance to the naked eye as well as their microscopic characteristics. Colorectal adenomas are treated by removing them, as there is a risk they could turn into cancer if left in the body.
The irregular growth of the normal glands in the gastrointestinal tract results in a colorectal adenoma. In the gastrointestinal tract, the colorectal portion is a tube-like structure through which partially digested food and waste products move. The part of the gastrointestinal system that comes into contact with digesting food is made up of epithelial tissue. Beneath this epithelial tissue are a variety of glands that produce substances that are important for the digestion process. The abnormal proliferation of these glandular structures is what constitutes the adenoma.
The diagnosis of colorectal adenoma is usually made by performing a colonoscopy. In this procedure, doctors insert a tube containing a camera through the anus to view the inside surface of the colon and rectum. Any abnormally protruding tissue is removed during the procedure. It is then sent to a pathologist for microscopic analysis. Colorectal adenomas can also be detected with other imaging techniques, such as a CT scan or an air-contrast barium enema, but colonoscopy has the added benefit of being able to remove the adenoma immediately.
Removal is the proper treatment for a colorectal adenoma. The reason removal is needed is that about five percent of colorectal adenomas turn into colorectal cancer. If diagnosed by colonoscopy, the adenoma is removed as soon as it is seen. Patients who are diagnosed with other imaging methods require follow-up colonoscopy to remove the adenoma. After removal, patients are monitored by performing a repeat colonoscopy at least every five years.
Three types of adenomas can be observed during colonoscopy. They are named according to their structure and appearance. Sessile adenomas are structures with broad, broad bases. Similar to sessile adenomas, flat adenomas also have large bases connected to the inner wall of the gastrointestinal tract, but these growths typically are at least twice as long in diameter as they are in height. Pedunculated adenomas are the third type and are mushroom-shaped with a narrow stalk connecting the inner intestinal surface to the growth.
In addition to being classified based on its appearance to the naked eye, a colorectal adenoma can be classified based on its microscopic characteristics. This determination is often made by a pathologist who examines the adenoma after it is removed. One classification is a villous adenoma; in this subtype, the abnormal glands that make up the adenoma have an elongated pattern. Tubular adenomas, another subtype, have glands with a branching structure. A combination of the two types of microscopic structures is described with the term tubulovillous.
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