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Presented by : Dwi Damar Andriyani Consultant : dr. Edy Moeljono , Sp.Rad (K)RA

BOOK READING DAVID SUTTON VOLUME 1 PAGE 637-647. THE LARGE BOWEL COLORECTAL TUMOUR (POLYPS). Presented by : Dwi Damar Andriyani Consultant : dr. Edy Moeljono , Sp.Rad (K)RA. Polyps. Mucosal elevation Some malignant potensials Sporadically or part of polyposis syndrome

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Presented by : Dwi Damar Andriyani Consultant : dr. Edy Moeljono , Sp.Rad (K)RA

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  1. BOOK READING DAVID SUTTON VOLUME 1 PAGE 637-647 THE LARGE BOWEL COLORECTAL TUMOUR (POLYPS) Presented by :DwiDamarAndriyani Consultant : dr. EdyMoeljono, Sp.Rad (K)RA

  2. Polyps • Mucosal elevation • Some malignant potensials • Sporadically or part of polyposis syndrome • 50-65% : Adenomatous 10-30% : Metaplastic (hyperplastic) 10-30% : Inflamatory polyps Another very rare : Hamarthoma, Lipoma

  3. Colorectal polyps and corresponding polyposis syndromes

  4. Radiographyc Appearance • Early lesion : Usually sessile • Double contrast barium: • Barium-coated nodule projecting into lumen • Negative defect • Ring shadow (Barium congregates in the angle polyps base with normal colonmeniscusring shadow) • Density increased comparison to adjacent mucosa

  5. Polyps Fig. 21.7 A small polyp where the meniscal rim of barium between thepolyp base and adjacent mucosa causes the 'bowler-hat' sign.

  6. Inflammatory Polyps • Produced by re-epithelialisastion ulseration colon (common follow ulcerative colitis) • Dramatic in appearance • Only mucosal tag • No malignant risk • Can be so numerouscolonic obstruction • Filliform

  7. Filiform polyposis Fig. 21.1 Barium enema reveals two patches of filiformpolyposisat the hepatic flexure in a patient with known Crohn's disease.

  8. Adenomas • Benigna neoplasm • Dysplastic • Potentially pre malignant • Size • Dysplasia Predictor • Villlocity

  9. Adenomas......cont • Incidence increase with age • Classified • Tubular • Tubulovillous • Villous • Greatest malignant potential • Prospensity for rectosigmoid location • Characteristic • Being broad based • Relatively large • Frond-like surface

  10. Adenomas......cont Fig. 21.3 A sigmoid villous adenoma, evidenced by a fine carpeting offrond-like projections.

  11. Benigna or maligna? • Can’t be done with its morphologhy • Size : best predictor • (5-9) mm 0,9% malignant • (10-20)mm 5-10% malignant • >20 mm 10-50% malignant

  12. Resume Colorectal polyps • Classification • Solitary • Polyposis • Hyperplastic polyps (Filiform polyposis) • Adenomas

  13. Quiz • What kind of radiological examination that produce this picture? • Please, describe this picture! • What the most likely diagnosis for this picture? Fig. 21.1 page 637

  14. Terimakasih

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