Inflammatory pseudopolyp

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:

• Juvenile polyp.
• Mucosal prolapse.
  • Solitary rectal ulcer.

Images

• 

  IP - very low mag.

• 

  IP - low mag.

• 

  IP - intermed. mag.

• 

  IP - high mag.

www:

• Pseudopolyp (humpath.com).
• Pseudopolyp (ucsf.edu).

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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.

 POLYP (AT EDGE OF DIVERTICULUM), SIGMOID COLON, POLYPECTOMY:
- GRANULATION TISSUE AND SCANT BENIGN EPITHELIUM.
- NO EVIDENCE OF 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.

Alternate

The sections show a fragment of tissue with scant benign epithelium, acute and chronic inflammation (neutrophils and plasma cells predominantly), abundant blood vessels with reactive endothelial cells and plump stromal cells. Occasional stromal cells have nuclear hyperchromasia but do not show significant atypia.

See also

• Gastrointestinal tract polyps.
• Mucosal prolapse syndrome.
• Colon.
• Nasal polyps.