The non-malignant tumors of the rectum are commonly classified as polyp The term is applied to any outgrowth having a narrow, peculated attachment and a large pendulous extremity. Any benign tumor occurring in the rectum as a rule becomes peculated in time, due to the weight of the mass and the straining during defecation. The anew-rec-tale region is commonly the site of these benign growths. They are found in children at almost any age, but occur more frequently in adults. They may be single or multiple, large or small, rough or smooth, globular or elongated in shape. In consistency they vary with their structure, being soft or hard, friable or tough. While found most frequently in the rectum they may occur in any part of the intestine. As a rule they are the color of the normal mucous membrane but may be pale or of a purplish hue.

Sometimes inflammatory affections of the intestinal mucous membrane and sub mucosa are the seat of inflammatory growths involving both the connective tissue and epithelial layer. These growths are usually the result of necrotic or inflammatory processes which produce swellings or protuberances into the lumen of the gut, resembling non-malignant or malignant pathological conditions. Most non-malignant tumors found in the rectum and anal canal are in the form of polyp which involve the mucous membrane.

The term polyps as a rule is used to designate the peculated growth involving the mucous membrane of the rectum, irrespective of its histological character. The rectum may be the seat of almost any of the histological forms of begin neoplasms which are found in the same character of tissue at other portions of the body. The following types are the most common: 1. Hypertrophied solitary follicles: 2. Adenoid, 3. Fibroid, 4. Lymphoma, 5. Myxomatosis, 6. Myopia, 7. Andromache, 8. Lymphatic

Hypertrophied Solitary Follicles are the most common form of polyp found in children. They are of a soft, mucous type consisting of alveolar tissue, the meshes of which are filled with a viscid fluid. The mucous glands of the intestinal wall are sometimes dragged into the tumor during its process of formation which may give it the appearance of a cyst. Sometimes the tumor will contain true Lieberman tubules.

Adenoid or glandular polyp, are composed of typical glandular epithelium which corresponds to the normal tissue in which they are found. By comparison they are found in the intestinal tract more commonly than any other form of benign outgrowths, and are encountered in the rectum far more frequently than in any other portion of the intestine. Simple adenoidal are common in children but comparatively rare in adult life, excepting when they have followed some irritating discharge from the intestine above. Malignant adenoidal are more common in persons past middle life and are seldom seen during childhood. The typical adenoids have a well-marked basement membrane between the cell layer and the stoma, but when the growth progresses rapidly and atypically this basement membrane may be absent. The gland cells are the dominant agents and while the stoma is essential to the growth, the cells precede the formation of the stoma Denominators polyp may be single, multiple, and disseminated and may occur in any part of the rectum. However they are most often located at the junction of the movable and fixed portions of the rectum.

There seems to be some relation between the existence of rectal adenoids and similar growths located in the pharynx, as pointed out by Ant This condition seems evidently the result of a lymphoid hypertrophy manifested in the constitutional condition.

Adenoidal when completely removed do not recur as a rule, or infect neighboring lymphatics; or give rise to secondary deposits. When death results from adenoid it is as a result of mechanical obstruction, depending upon the situation and size of the tumor. Adenoidal in the adult are generally considered as having a very strong tendency to become malignant, either in the simple or multiple varieties. The multiple variety seem to have the greatest tendency to this malignant transformation.

Fibroblast of the rectum and anal region are composed of fibrous connective tissue formed from the sub mucosa and often grow to a considerable size. True fibroid is infrequently found in this region. The fibrous tissue is arranged in wavy bundles and ordinarily contains few blood vessels.

When located upon the skin about the anus they present a hard, glistening tumor, having a broad base. When in the rectum they present a pale, nodular and firm peculated tumor. Sometimes they are of the cavernous type. When the fibroid remains within the intestinal wall it is of spherical or ovoid shape, closely attached to the muscular coat and the mucous membrane is movable over it. The symptoms then are like those of mucous polyp

Diplomata are tumors composed of adipose tissue principally. Their favorite site is in the upper rectum but they are occasionally found in the per-rectal tissue and on the buttocks. When within the rectum they develop in the sub mucous layer and assume a polypeptide shape with a pedicab They may grow so large as to drag the rectal wall and cause a prolapse. They are dark brown in color and are characterized by an unusually long pedicab Sometimes these tumors drag the rectal wall to such an extent as to cause a peritoneal imagination into the pedicab, which is important from a surgical standpoint. When peritoneal involvement is suspected the tumor should be removed by an incision of the mucous membrane and the wound closed by sutures.

These tumors are composed largely of isolated cells of a Stellated appearance, separated from each other by a matrix containing cumin The blood vessels within this matrix are large and thin-walled. A true Lippmann is of rare occurrence, and as a rule the tumor presents more or less fibrous tissue or cartilaginous masses. In other specimens, portions may present a sarcomas-cell type, resembling the spindle cells.