Juvenile polyp

Juvenile polyp
Diagnosis in short
Juvenile polyp (stomach). H&E stain.
LM	eroded, smooth or lobulated surface, pedunculated, increased lamina propria (LP) +/- edema, cystically dilated gland, +/-inflammation
LM DDx	inflammatory polyp, hyperplastic polyp of the stomach, Cronkhite-Canada syndrome
Site	gastrointestinal tract polyps
Syndromes	Juvenile polyposis syndrome
Prevalence	uncommon
Prognosis	benign itself; multiple = marker of increased risk of malignancy
Clin. DDx	other GI polyps

Juvenile polyp, abbreviated JP, is a type of hamartomatousgastrointestinal polyp.

In adults, it is known as a retention polyp.

General

• Uncommon.

May be part of a syndrome:

• Juvenile polyposis syndrome (JPS) - see JPS article for criteria.
• Cronkhite-Canada syndrome.
• Cowden syndrome.

Gross

• Mushroom-like shape.

Microscopic

Features:

• Eroded, smooth or lobulated surface.
• Pedunculated.
• Increased lamina propria (LP) +/- edema.
• Cystically dilated gland.
• Often inflammed.

Mnemonic DIES = dilated glands, increased LP & inflammation of the LP, eroded/smooth surface, stalk.

Notes:

• May have nuclear changes like those seen in adenomatous polyps.

DDx:

• Inflammatory polyp.
• Hyperplastic polyp of the stomach - less lamina propria, foveolar hyperplasia (long tortuous glands).
• Cronkhite-Canada syndrome - have changes in the surrounding mucosa, clinical findings (nail atrophy, skin pigment, alopecia).

Images

www:

• Juvenile polyp (nature.com).

• 

  Juvenile polyp of the stomach - very low mag. (WC/Nephron)

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  Juvenile polyp of the stomach - very low mag. (WC/Nephron)

IHC

• Usually none.

Notes:

• IHC can be used if it is suspected to have dysplasia (p53, Ki-67).
  • p53 mutations in dysplastic epithelium -- negative stain (normal).

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RECTOSIGMOID POLYP, BIOPSY: 
- RETENTION POLYP. 

See also

• Gastrointestinal tract polyps.