A polyp is an abnormal growth of tissue projecting from a mucous membrane, the moist inner lining of an organ. The term ‘pedunculated’ describes the polyp’s specific shape, signifying that the growth is attached to the surface by a narrow, elongated stalk. This structure gives it a mushroom-like appearance, consisting of a head and the connecting stalk.
Anatomy and Common Locations
The defining feature of a pedunculated polyp is its structure: a head of tissue connected to the organ wall by a thin stalk. Its shape contrasts with a sessile polyp, which is flat and grows directly on the surface without a stalk. The stalk on a pedunculated polyp often makes it easier to spot during diagnostic procedures.
These growths are most frequently found in the large intestine (colon), but can also develop in the stomach, uterus, cervix, and nasal passages. In the uterus, pedunculated polyps can grow large enough to protrude through the cervix.
Symptoms and Detection Methods
Most pedunculated polyps, particularly those in the colon, do not cause symptoms when they are small, which underscores the importance of routine screening. When symptoms do occur, they depend on the polyp’s location and size. For colorectal polyps, signs can include blood in the stool, unexplained changes in bowel habits, and abdominal pain. Slow, chronic bleeding from a polyp can also lead to iron deficiency anemia, causing fatigue and weakness.
The most effective method for detecting polyps in the colon is a colonoscopy. This procedure uses a thin, flexible tube with a camera to visualize the entire inner lining of the colon. If a polyp is found, it can often be removed at the same time. For polyps in the stomach or upper digestive tract, a similar procedure called an upper endoscopy is used.
Management and Malignancy Risk
While many polyps are harmless, some have the potential to develop into cancer over time. The risk depends on the type of polyp, which is determined by examining the tissue under a microscope. Adenomatous polyps, or adenomas, are the most common type and are considered precancerous. Polyps with a higher percentage of a specific growth pattern, known as villous, or those larger than one centimeter, carry an increased risk.
Standard management for pedunculated polyps is removal, a procedure called a polypectomy. The stalk of a pedunculated polyp often makes it easier to remove cleanly in one piece using a wire loop snare. Once removed, the polyp is sent to a pathology lab for analysis.
A pathologist examines the tissue to determine its type and look for cancerous cells or high-grade dysplasia, where cells appear more disorganized, indicating a higher cancer risk. Based on these findings, such as the polyp type, size, and whether cancer cells have invaded the stalk, a doctor will recommend a schedule for follow-up colonoscopies.