Biopsy of gastrointestinal polyps

Biopsy of gastrointestinal polyps — is a pathomorphological study of tissue fragments or completely removed neoplasms protruding above the surface of the mucous membrane of the esophagus, stomach or intestine. Since it is impossible to accurately determine the nature of a polyp by eye, its histological analysis is a mandatory step to exclude precancerous conditions and early forms of cancer.

Research objective: The main task is the morphological classification of the polyp and the assessment of its degree of danger. The study allows you to distinguish benign hyperplastic formations from adenomatous polyps, which have a high potential for malignancy (degeneration into a malignant tumor).

What does the pathologist evaluate:

• Histological type: determining the type of polyp (tubular, villous or tubulovillous adenoma, serrated or hyperplastic polyp).

• Degree of dysplasia: assessment of the severity of cellular changes (low or high grade), which directly indicates the risk of developing cancer.

• Radicality of removal: checking the "resection margin" - whether there are any atypical cells left at the site of the polyp's cut-off from the organ wall.

• Signs of infestation: checking whether tumor cells have begun to grow into the deeper layers of the mucous membrane.

Clinical significance: The result of the study determines the further tactics of patient surveillance. For example, the detection of villous adenoma with high-grade dysplasia requires a control colonoscopy in a year, while in the case of a hyperplastic polyp, the next examination may be prescribed in 5–10 years. Histology of the polyp is the most effective way to prevent colorectal cancer and stomach cancer.

When is it prescribed:

• detection of any neoplasms on the pedicle or broad base during gastroscopy or colonoscopy;

• removal of polyps (polypectomy) to confirm their benign nature;

• monitoring the condition of patients with familial adenomatous polyposis;

• follow-up after removal of large or complex polyps in the past.