Colon tumor
Hyperplastic polyp of colon

Author: Charanjeet Singh, M.D. (see Authors page)

Revised: 12 December 2016, last major update May 2012

Copyright: (c) 2003-2016,, Inc.

PubMed Search: "Hyperplastic polyp" colon

See Also: Hyperplastic polyp of colon with misplaced epithelium, Inverted hyperplastic polyp of colon
Cite this page: Hyperplastic polyp of colon. website. Accessed January 21st, 2018.
Definition / general
  • 90% of all polyps
  • Usually patients age 50 + years, often in rectosigmoid
  • Present in 30 - 50% of normal individuals (85% of adults in Western world versus 2% in third world countries)
  • Due to delayed shedding of surface epithelial cells
  • Associated with cigarette smoking (Cancer Causes Control 2005;16:1021)
  • Previously considered to have no / minimal malignant potential (Arch Intern Med 2005;165:382), except for those in hyperplastic polyposis syndrome
  • Right sided hyperplastic polyps are molecularly more similar to serrated adenomas than to left sided hyperplastic polyps and are associated with cancers that show microsatellite instability (but see J Clin Pathol 2004;57:1089)
  • Intermediate (6 - 9 mm) sized polyps are usually right sided and are associated with synchronous colorectal carcinoma (J Gastroenterol Hepatol 2005;20:1572)
Case reports
Gross description
  • Small (< 5 mm), sessile, usually on top of mucosal folds, multiple and same color as surrounding mucosa
  • Lesions up to several cm may occur in right colon, but may be serrated adenomas
Gross images

Images hosted on other servers:

Hyperplastic polyp

Microscopic (histologic) description
  • Well formed, elongated glands and crypts with serrated (saw tooth) or star-shaped appearance resembling secretory endometrium
  • Mixture of goblet cells (with abundant mucin) and absorptive cells
  • Bland cytology with eosinophilic cytoplasm, well defined brush borders and basal nuclei
  • Thickened basement membrane; Paneth cells in 8%; may have multinucleated giant cells (Am J Surg Pathol 2005;29:912)
  • Cells at base of crypt may have nuclear elongation, crowding and increased mitotic rate but this is not adenomatous change
  • May be splaying of muscularis mucosa fibers into submucosa
  • Large hyperplastic polyps may have adenomatous foci
Microscopic (histologic) images

Images hosted on other servers:

Right sided vs. left sided polyps

Serrated crypts

Various images

Molecular / cytogenetics description