A patient with a history of familial polyposis undergoes a diagnostic polypectomy. Which of the following types of polyps is most likely to be found?
## **Core Concept**
Familial adenomatous polyposis (FAP) is an inherited condition characterized by the development of hundreds to thousands of polyps in the colon and rectum. It is caused by mutations in the **APC (adenomatous polyposis coli) gene**, which is a tumor suppressor gene. The polyps in FAP are primarily adenomatous.
## **Why the Correct Answer is Right**
The correct answer, **adenomatous polyps**, is the type of polyp most commonly associated with familial adenomatous polyposis (FAP). FAP is characterized by the development of numerous adenomatous polyps throughout the colon and rectum, which have the potential to progress to colorectal cancer if left untreated. Adenomatous polyps, also known as adenomas, are benign tumors that arise from glandular tissue and have the potential for malignant transformation through the adenoma-carcinoma sequence.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Hyperplastic polyps are typically small, found in the distal colon, and are not usually associated with FAP. They have very low malignant potential.
- **Option B:** Inflammatory polyps are associated with inflammatory bowel disease (IBD) rather than FAP. They are a result of chronic inflammation in the bowel.
- **Option D:** Peutz-Jeghers polyps are characteristic of Peutz-Jeghers syndrome, a different genetic disorder that involves the development of hamartomatous polyps in the gastrointestinal tract and an increased risk of certain cancers.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that patients with FAP often undergo prophylactic colectomy due to the high risk of developing colorectal cancer. Early diagnosis and management are crucial, and screening for FAP typically begins in late childhood to early adolescence.
## **Correct Answer:** B. adenomatous polyps