Inflammatory pseudopolyp

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Inflammatory pseudopolyp is a benign polypoid lesion usually seen in the context of inflammatory bowel disease.

Inflammatory pseudopolyp
Diagnosis in short

Inflammatory polyp. H&E stain.

LM polypoid shape, inflammatory cells - esp. neutrophils
LM DDx juvenile polyp, mucosal prolapse, adenomatous polyps
Site colon, rectum, others

Clinical history +/-inflammatory bowel disease
Prevalence not common
Prognosis benign
Clin. DDx other types of polyps
Inflammatory pseudopolyp
External resources
EHVSC 9992

It is also referred to as inflammatory polyp.

General

  • Not a true polyp.
  • The label inflammatory pseudopolyp = inflammatory bowel disease (IBD).
    • If there is no history of IBD... reconsider the diagnosis.

Microscopic

Features:

  • Polypoid shape.
  • Inflammation - esp. neutrophils - key feature.

Negatives:

  • No nuclear atypia.
    • May have focal nuclear hyperchromasia and nuclear enlargement.
  • No dilated glands.

DDx:

Images

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SIGMOID COLON POLYP, PERI-DIVERTICULAR, BIOPSY:
- INFLAMMATORY PSEUDOPOLYP.
POLYP, DESCENDING COLON, BIOPSY:
- INFLAMED POLYPOID FRAGMENT OF COLORECTAL-TYPE MUCOSA.
-- NEGATIVE FOR DYSPLASIA.

Micro

The sections show a fragment of colorectal mucosa with focal ulceration, acute inflammation and a well-vascularized stroma with plump stromal cells. Occasional stromal cells have nuclear hyperchromasia.

See also

References

  1. Aust, DE.; Rüschoff, J. (Jul 2011). "[Polyps of the colorectum: non-neoplastic and non-hamartomatous].". Pathologe 32 (4): 297-302. doi:10.1007/s00292-011-1435-1. PMID 21607734.