What type of colonic lesion is indicated in a patient with chronic occult gastrointestinal bleeding?

• A. Hyperplastic polyp
• B. Inflammatory pseudopolyp
• C. Tubular adenoma
• D. Juvenile polyp

Answer: (C)

In cases of chronic occult gastrointestinal bleeding, the presence of a tubular adenoma is significant because these lesions are considered precursors to colorectal cancer. Tubular adenomas are types of polyps that arise from the epithelial lining of the colon and have the potential for dysplasia and malignant transformation. They often present with bleeding, especially in patients who have a long-standing history of gastrointestinal issues.

The risk of malignancy increases with the size and degree of dysplasia within the adenoma, making their identification and monitoring particularly important in patients presenting with symptoms like chronic bleeding. Thus, in the context of chronic occult bleeding, a tubular adenoma would be a more clinical concern due to this association with colorectal cancer than the other types of lesions listed. Hyperplastic polyps, inflammatory pseudopolyps, and juvenile polyps typically have low potential for malignancy and are less likely to be involved in chronic bleeding contexts than tubular adenomas.