Polyp Stalk

Polyps may lake two forms. They can occur with stalks or without stalks (Haggitt et al, 19fJ5). Polyps, or adenomas, with stalks are called peduncvlated. while those without stalks are called sessile (Figure 11,1), When discovered in the doctor s... 

Several species of stalked, plantlike hydrozoans and octo-corals form small colonies in shallow intertidal waters. These organisms spend part of their lives as medusae and part as polyps. Like anemones, they gather food with their small tentacles. A less common but more conspicuous cnidarian along the shore is the jellyfish. Most jellyfish found in the intertidal zone are simply washed in, although the stalked jellyfish makes its home there. 

Fig.4.3. Despite the large obstructing tumour in the transverse colon near the splenic flexure white arrows), the proximal colon is clean black arrowheads). There is a large stalked polyp in the sigmoid covered by a thin barium layer white arrowhead). Ultra-low dose on a 64-slice scanner 140 kV- 10 mAs...

Fig. 4.4.a Stalked polyp in the sigmoid (white arrow) with some tagged fluid (black arrowheads), b Corresponding endoluminal view showing the head of the polyp (white arrow)... 

Fig. 4.17.a Supine view of the transverse colon showing a mucous filament (white arrowhead) attached to a prominent semicircular fold (white arrow), mimicking a stalked polyp. Some partially tagged foam (black arrowhead), b Corresponding endolu-minal view showing the filament mimicking the stalk of a polyp (white arrows). The filament has an irregular shape. The foam is also visible (black arrows)... 

Fig. 4.18.a Polyp with a small stalk in the descending colon (white arrows), b Corresponding endoluminal view showing the stalk (white arrows) and the head (white arrowhead) of the polyp... 

A consistent reporting style is to measure the polyp head, with exclusion of the stalk. Thus, choosing the image where the polyp head and stalk are best discerned provides the more accurate and reproducible measurement (Fig. 7.5). 

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... 

Fig. 8.6a,b. False negative diagnosis rectal balloon catheter hiding rectal polyp a prone scan after removing the rectal balloon clearly shows a large stalked polyp (arrow) b the polyp is hidden by the rectal balloon on supine image.(orrow). Lesson Thidc rectal balloon catheters can hide rectal lesions. Therefore, remove rectal balloon catheter on prone scan... 

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). 

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... 

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... 

Hyperplastic polyps are the most common polyps of epithelial origin and as a rule are multiple and found throughout the stomach. They have an association with chronic fundic gastritis, and although this presents an increased risk for malignancy, hyperplastic polyps themselves do not have a malignant propensity. At endoscopy these polyps present from small nodules to 15-mm proliferative lesions, with or without a stalk (Fig. 3.30). Biopsy is only necessary in large polyps to establish their true nature. 

Fig. 3.31. An adenomatous polyp with a stalk, situated in the gastric antrum...

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