Ans. B. Adenomatous polyp.. (Ref. Robbin's pathology 8th/pg. 618)Robbin's pathology 8th/pg. 618....."Adenomas are neoplastic polyps that range from small, often pedunculated, tumors to large lesions that are usually sessile. Incidence of adenomas in the small intestine is very low compared to those arise in the colon.The prevalence of colonic adenomas is 20% to 30% before age 40, rising to 40% to 50% after age 60. Males and females are affected equally. There is familial predisposition to sporadic adenomas, accounting for about a fourfold greater risk for adenomas among first-degree relatives, and also a fourfold greater risk of colorectal carcinoma in any person with adenomas"Polyps of the Large Intestine.TypeHistologic DiagnosisNeoplasticAdenomaTubular adenoma (adenomatous polyp)Tubulovillous adenoma (villoglandular adenoma)Villous adenoma (villous papilloma)CarcinomaHamartomasJuvenile polypPeutz-Jeghers polypInflammatoryInflammatory polyp (pseudopolyp) Benign lymphoid polypUnclassifiedHyperplastic polypMiscellaneousLipoma, leiomyoma, carcinoid# Inflammatory polyps have no malignant potential. Cancer developing in asso with hamartomas is rare.# Hyperplastic polyps are not neoplastic and therefore do not become malignant.# Juvenile polyps- are hamartomatous proliferations, mainly of lamina propria, enclosing widely spaced, dilated cystic glands.- They occur most frequently in children younger than 5 years old but also are found in adults of any age; in the latter group they may be called retention polyps.- Irrespective of terminology, the lesions are usually large in children (1-3 cm in diameter) but smaller in adults; they are rounded, smooth, or slightly lobulated and sometimes have a stalk as long as 2 cm.- In general, they occur singly and in the rectum, and being hamartomatous have no malignant potential.- Juvenile polyps may be the source of rectal bleeding and in some cases become twisted on their stalks to undergo painful infarction.# Syndromes of juvenile polyposis have been defined:# (1) Juvenile polyposis syndrome: (1/100,000 population): (juvenile polyposis and ectodermal lesions).# (2) Bannayan-Riley-Ruvalcaba syndrome: (juvenile polyposis and macrocephaly and genital hyperpigmentation), and# (3) Cowden's disease (juvenile polyposis and facial trichilemmomas, thyroid goiter and cancer, and breast cancer).# (4). Although juvenile polyps are hamartomas with a low malignant potential, the risk of GI cancer is increased in familial juvenile polyposis patients and their relatives. The lifetime risk of colorectal cancer with juvenile polyposis syndrome is 30-60%. Furthermore, hamartomas can coexist with adenomas, and one must not assume that a polyp is a hamartoma without proof. Colonoscopic excision is performed for large or symptomatic (bleeding, intussusception) lesions. Some juvenile polyps autoamputate. Colectomy is required in patients with familial juvenile polyposis.# Peutz-Jeghers syndrome- is an uncommon autosomal dominant disease (1/200,000 population) in which multiple hamartomatous polyps appear in the stomach, small bowel, and colon.- There is melanotic pigmentation of skin and mucous membranes, especially about lips and gums.- Until recently the Peutz-Jeghers hamartomas were thought to be without malignant potential, but adenomatous changes and the development of malignancy have been described.- The lifetime risk of colorectal cancer has been reported to be 39%.- Polyps are generally removed only if symptomatic, but patients should undergo continued surveillance. Carcinoma also develops at an increased rate in other tissues, eg, stomach, duodenum, pancreas, small intestine, and breast.