Is mild hyperplasia of villous tubular adenoma hereditary?

Mild hyperplasia of villous tubular adenoma is usually a type of intestinal polyp. Intestinal polyps can be divided into several stages. About 90% of juvenile polyps occur in children under ten years old, and boys are more likely to have them than girls. In addition, there are various types including hyperplastic polyps, lymphoid polyps, inflammatory polyps, etc.

Any polyp-like lesions that protrude from the mucosal surface into the intestinal cavity are called polyps before the pathological nature is determined. According to the pathology, they can be divided into: adenomatous polyps (including papillary adenomas) are the most common, inflammatory polyps, which are the result of hyperplasia of the intestinal mucosa due to long-term inflammatory stimulation, hamartoma-type polyps, and others, such as hyperplastic polyps formed by mucosal hypertrophy, lymphoid tissue hyperplasia, carcinoid and other diseases. Clinically, colorectal polyps are the most common and have more obvious symptoms.

Common intestinal polyps are classified as follows:

1. Juvenile polyps: About 90% occur in children under 10 years old, more commonly in boys. The appearance is round or oval, with a smooth surface. 90% grow within 25 cm from the anus, most are less than 1 cm in diameter, the vast majority have pedicles, and about 25% are multiple. Histologically, they appear as well-differentiated glands of irregular size, some of which form cystic dilations, store mucus, have interstitial hyperplasia, and have more inflammatory cell infiltration, and sometimes ulcers form on the surface. Secondary polyps generally do not become malignant.

2. Hyperplastic polyps: Hyperplastic polyps are the most common type of polyps, also known as metaplastic polyps. Most of them are distributed in the distal large intestine and are generally small, with a diameter rarely exceeding 1 cm. They appear as a small drop-shaped protrusion on the mucosal surface with a smooth surface and a wide base. Multiple polyps are also common. Histologically, this type of polyp is formed by enlarged and regular glands. The increase in glandular epithelial cells causes the skin to shrink and present a serrated shape. The cell nuclei are regularly arranged, and their size and chromatin content change very little. Nuclear division phases are rare. Its important feature is that mature cells appear in the middle and lower sections of the intestinal gland crypts. Hyperplastic polyps do not become malignant.

3. Lymphoid polyps: Lymphoid polyps, also known as benign lymphomas, are more common in adults aged 20 to 40 years old, but can also occur in children. They are slightly more common in males and are more common in the rectum, especially the lower rectum. Most are single, but can also be multiple, with varying sizes, ranging from a few millimeters to 3 to 4 centimeters in diameter. The surface may be smooth or lobed or may have superficial ulceration. Most of them are pedicleless, and those with pedicles are short and thick. Histologically, it appears as well-differentiated lymphoid follicle tissue confined to the submucosal layer and covered with normal mucosa. Germinal centers can be seen, which are often enlarged and have mitotic figures, but there are no mitotic figures in the surrounding lymphocytes, and the proliferating follicles are clearly demarcated from the surrounding tissue. Lymphatic polyps do not become cancerous. Less common is benign lymphatic polyposis. It manifests as a large number of lymphoid polyps. It is a small spherical polyp of 5 to 6 cm and is more common in children. Histological changes are similar to those of lymphoid polyps.

4. Inflammatory polyps: Inflammatory polyps, also known as pseudopolyps, are polyp-like granulomas caused by long-term chronic inflammation of the intestinal mucosa. This type of polyp is often seen in the diseased intestines of ulcerative colitis, chronic schistosomiasis, amoebic dysentery, intestinal tuberculosis and other diseases. They are often multiple, mostly small, with a diameter of less than 1 cm. They may increase in size with a long course of illness. The appearance is mostly narrow, long, with a wide pedicle and irregular distal end. Sometimes it is bridge-shaped, with both ends attached to the mucosa and the middle part free. The histological manifestations are fibrous granulation tissue, and the epithelial components may also show mesenchymal changes, but it is still uncertain.