Difference between Adenomas and Hyperplastic Polyps

Differences Treatment Diseases

It is important to note that there are two types of polyps: adenomas and hyperplastic polyps (abnormal tissue growth on a mucous membrane like colon or endometrium). There is a risk of malignancy in adenomatous polyps (cancerous). On the other hand, hyperplastic polyps are the least likely to progress to malignancy.

What are Adenomas?

The most prevalent kind of polyps are adenomatous polyps. The large intestine's mucous membrane, which is the wet inner lining of several organs and bodily cavities, seems to grow or generate these gland-like extensions (colon). They come in three distinct forms, known as adenomas: tubular, villous, and tubulovillous.

What are Hyperplastic Polyps?

The colon or large gut lining is the site of hyperplastic polyps. A hyperplastic polyp is an expansion or development of additional tissues that develop from preexisting ones; it is typically harmless. They proliferate along the digestive tract and other parts of the body where damaged tissues have been healed.

Differences: Adenomas and Hyperplastic Polyps

The following table highlights the major differences between Adenomas and Hyperplastic Polyps −

Characteristics	Adenomas	Hyperplastic Polyps
Definition	Polyps that become malignant over a period of time are termed as adenomas or adenomatous polyps.	Polyps that possess the least chance of becoming malignant or cancerous are termed as hyperplastic polyps.
Microscopical appearance	Dysplastic cytologic features of an adenoma.	Saw-toothed epithelial pattern representing micropapillary luminal infoldings of columnar absorptive cells.
Macroscopically	Can be more than 1 cm	Less than 1 cm
Risk factors	People are more likely to develop colorectal cancer if they − Are fat (obese) Smoke cigarettes Lack of physical activity and exercise Eat too much processed and red meat Consume too much alcohol Have type 2 diabetes	If happens in colon, certain risk factors include Being too fat (obese) Being male Consuming a lot of red meat Not enough physical activity and exercise Too much tobacco smoking Heavy alcohol consumption Bowel condition with inflammation (diseases called Crohn’s disease) Presence of polyps in the right (ascending) colon If happens in the stomach, the risk factors include − Possessing a stomach infection due to Helicobacter pylori bacteria Possessing a genetic medical history of malign (cancerous) stomach polyps Usage of medication like proton pump inhibitor for stomach acid
Types	Tubular − Small, pedunculated polyps composed of tiny, rounded or tubular glands and protrudes out in the lumen (channel within a tube or tubular organ) of the colon Villous − larger and sessile, enveloped by slender. The growths are lined by dysplastic glandular epithelium (expansion of immature cells) whose risk of cancer is especially high up to 50% Tubulovillous − polyps containing >25% of both tubular and villous adenomas	Pedunculated − long in size and narrow with a stalk that is mushroom like Sessile −smaller/tinier and squat-looking Serrated −Wider near the bottom, short and flat above
Location	Proximal to rectosigmoid junction	Distal to rectosigmoid junction

Conclusion

Adenomas require treatment and surveillance, while Hyperplastic Polyps do not require any treatment because they are least likely to progress and become cancerous.

Vineet Nanda

Updated on: 01-Mar-2023

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