Colonic Polyps Differential Diagnoses

Updated: Mar 09, 2020
  • Author: Gregory H Enders, MD, PhD; Chief Editor: BS Anand, MD  more...
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Diagnostic Considerations

The differential diagnosis of colonic polyps varies, depending on the age of the patient and the presenting symptoms. A family history of polyposis is very significant because it raises the possibility of an inherited susceptibility, such as familial adenomatous polyposis (FAP) or other polyposis syndromes. Moreover, the differential diagnosis can be broad if the patient presents with rectal bleeding or diarrhea.

Conditions to consider in the differential diagnosis include the following:

  • Sporadic polyps associated with aging

  • Benign adenoma/hyperplastic polyp

  • Pseudopolyps associated with mucosal inflammation

  • Juvenile polyposis

  • Basal cell nevus syndrome (includes basal cell carcinomas and colonic hamartomatous polyps)

  • Turcot syndrome (includes polyps, medulloblastoma, congenital hypertrophy of the retinal pigmented epithelium [CHRPE], and glioblastoma multiforme)

  • Cowden syndrome (includes polyps, fibrocystic disease, breast cancer, and thyroid cancer)

  • Hereditary nonpolyposis colorectal cancer (HNPCC)/Lynch syndrome

  • Hyperplastic polyposis

Differential Diagnoses