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Histopathologische Differenzierung der Darmpolypen

  • James Mueller
  • Elke Mueller
  • Manfred Stolte
Part of the Molekulare Medizin book series (MOLMED)

Zusammenfassung

Bei einer Vielzahl hereditärer Syndrome des Magen-Darm-Trakts entwickeln sich Darmpolypen. Histopathologisch lassen sich grundsätzlich 3 Formen unterscheiden:
  1. 1.

    Syndrome mit epithelialen Polypen: Die epithelialen Polypen werden nochmals unterteilt in Neoplasien, d.h. die Adenome, und nichtneoplastische Formen, nämlich die hyperplastischen Polypen. Außerdem gibt es gemischte, adenomatös-hyperplastische Polypen bzw. Serrated Adenomas, die ebenfalls zu dem neoplastischen Typ der epithelialen Polypen gehören. Die meisten hereditären gastrointestinalen Syndrome sind mit der Entwicklung von Adenomen assoziiert. Polyposen, die mit der Entwicklung von hyperplastischen Polypen oder Serrated Adenomas einhergehen, sind sehr selten und zumeist nicht hereditär.

     
  2. 2.

    Syndrome mit hamartomatösen Polypen: Zu den hamartomatösen Polypen zählen Peutz-Jeghers-Polypen und juvenile Polypen. Sie sind durch die Proliferation und Disorganisation reifen ortsständigen Gewebes charakterisiert, wobei sowohl epitheliale als auch mesenchymale Elemente beteiligt sein können (Fenoglio-Preiser 1889 b). Hamartomatöse Polypen gelten nicht als neoplastisch, in ihnen können sich aber Neoplasien entwickeln (Foley et al. 1988).

     
  3. 3.

    Syndrome mit mesenchymalen Polypen: Die mesenchymalen Polypen können prinzipiell aus jedem Zelltyp des Mesenchyms (glatte Muskelzellen, Nervenzellen, Fettgewebezellen, Endothel usw.) hervorgehen. In Verbindung mit hereditären Syndromen wurden v.a. neurogene Polypen (Damiani et al. 1998, Shekitka u. Sobin 1994) und angiomatöse Polypen beschrieben (Sharma u. Howden 1998, Kjeldsen u. Kjeldsen 2000)

     
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© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • James Mueller
    • 1
  • Elke Mueller
    • 1
  • Manfred Stolte
    • 2
  1. 1.Chirurgische Klinik und PoliklinikTechnische Universität München Klinikum rechts der IsarMünchen
  2. 2.Institut für PathologieKlinikum BayreuthBayreuth

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