Polyp Pedunculated

Pol)q)s may take two forms. They can occur with stalks or without stalks (Haggitt et al, 1985). Polyps, or adenomas, with stalks are called pedunculated, while those without stalks are called sessile (Figure 11.1). When discovered in the doctor s... 

Fig. 7.1a-d. Multi-row CT colonography datasets showing a pedunculated (a, axial b, endoluminal view) and sessile (c, axial d, endoluminal view) polyp, located in the sigmoid colon... 

Types of papillomata were separated by Hodgson and Whitely into four morphologic groups (1) flat shiny lesions (2) sessile lesions resembling plantar warts (3) pedunculated skin tags (fibro-epithelial polyps) and (4) plaques (seborrheic keratoses). 

Moreover, the degree to which partial volume effects distort polyp morphology is determined by polyp size relative to the effective section thickness and section sensitivity profile, which are primarily a function of collimation, pitch and interpolation algorithm. For SSCT protocols with 3 mm and 5 mm collimation and pitch ranging between one and two, excellent depiction of 6-mm and 13-mm pedunculated polyps and 10 3 mm sessile polyps can be... 

Fig.7.6a,b. Pedunculated lesion in area of luminal narrowing and marked diverticulosis a axial 2D MPR view best visualizes the characteristic stalk (arrows) from the polyp head (arrowhead), compared to b b 3D volume rendered view, with polyp head shown (arrowheads), but stalk obscured by luminal narrowing and muscular hypertrophy... 

C-RADS describes the use of three morphologies of lesions sessile (broad based lesion whose width is greater than its vertical height), pedunculated (polyp with a separate stalk), and flat (polyp with vertical... 

First of all, there is the problem of insufficient awareness and familiarity with those lesions surveillance programs, based on the known adenoma-carcinoma sessile or pedunculated lesion, have mainly focused on identifying sessile of pedunculated polyps. This explains why flat lesions are frequently characterised as normal folds. As a rule, a thickened fold in an otherwise well distended colon should raise the question whether or not this lesion could represent a flat lesion. 

Pedunculated polyps however change in position between prone and supine images, and may moreover include gas between the stalk and the bowel wall, mimicking residual stool (Fig. 8.19). 

A pedunculated polyp can also mimick residual fluid (Fig. 8.20). 

Lesion size (mm) For lesions 6 mm or greater, single largest dimension of polyp head (excluding stalk if present) in either, MPR, or 3D views. The type of view employed for measurement should be stated Sessile-broad based lesion the width of which is greater than the vertical height Pedunculated-polyp with stalk... 

The diffuse form presents with multiple polypoid lesions and is called diffuse mucosal nodularity or malignant lymphomatous polyposis (O Connell and Thompson 1978 Callaway et al. 1997). The polyps appear smooth and sessile but can also be irregular or pedunculated. Often, the entire colon or a long segment is involved. 

Polyps maybe sessile, pedunculated, or flat (i.e., with the base measuring more than twice that of the height). Sessile polyps will possess polypoid morphology on axial, 2D multiplanar reformatted, and 3D endoluminal views (Fig. 14.23). When sessile polyps are of sufficient size (generally consid-... 

Fig. 14.24a-e. Pedunculated polyp a supine 2D axial image and b prone 2D axial image show a polyp in the descending colon associated with a stalk (arrowhead) c soft tissue window setting shows the head of the polyp to be of soft tissue attenuation. Note that the lesion changes position to the dependent position due to its long stalk d,e endoluminal appearances of the pedunculated polyp... 

Extremely rare in childhood, the urethral polyp is usually solitary and consists of a pedunculated structure, originating from the posterior urethra, developing in the bladder neck, which can prolapse in the urethra during micturition (Foster and Garrett 1986). Hematuria, nonneurogenic bladder-sphincter dysfunction and infection may reveal the abnormality. On ultrasound, it appears echo-genic. The main differential diagnosis of urethral polyp is an ectopic ureterocele that has ruptured either spontaneously (Fig. 6.8) or after endoscopic... 

Fig. 2.20a-d. Gastric Polyp. Double Contrast barium study (a) demonstrates a large pedunculated polyp in the antrum of the stomach. Endoscopy (b) and Endoscopic-ultrasound (c) confirm the pedunculated polyp which was confirmed as a non ulcerated fibroid polyp on histopathology (d)... 

At endoscopy these polyps are elevated lobular structures which may be semi-pedunculated, usually of a darker colour than the surrounding mucosa. Erosions and ulcers are signs of malignancy... 

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