Adenomatous Polyps and Polypoid Carcinomas of the Large Intestine

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Abstract
A study has been made of the pathologic changes in individual adenomatous polyps and polypoid carcinomas of the large intestine, illustrating the apparent transition from benign to malignant polyps. Adequate biopsy material, including the entire polyp, or at least tissue from the periphery and base of the lesion, must be submitted to the pathologist in order to obtain an accurate diagnosis. Carcinoma in situ and lack of uniform structure in the polyps are recognized as hazards in the diagnosis of biopsy material. The histologic demonstration of the presence or absence of invasion of the stalk is of prime importance in the selection of surgical treatment. Many pitfalls occur in such demonstration. It is assumed that unequivocal invasion of the stalk of a polyp by malignant cells is necessary before metastasis occurs. A lesion is presented which illustrates that a large portion of the base of the stalk of a polypoid carcinoma may not exhibit invasion even in the presence of metastasis. The necessity for close association and mutual understanding between the pathologist and the surgeon is emphasized for the proper care of each patient.

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