Colorectal xanthomatous polyp

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The colorectal xanthomatous polyp, also colorectal xanthoma, is a rare benign intestinal polyp.

Colorectal xanthomatous polyp
Diagnosis in short

Colorectal xanthomatous polyp. H&E stain.
LM abundant foamy histiocytes in the superficial lamina propria +/- superficial serrations (hyperplastic features)
LM DDx hyperplastic polyp, signet ring cell carcinoma, others
IHC CD68 +ve, pankeratin -ve
Site colon, rectum
Associated Dx +/-hyperlipidemia
Prevalence uncommon
Endoscopy polyp - red or yellow colour
Prognosis benign
Clin. DDx other colorectal polyps

Rectal xanthoma, colonic xanthoma, rectal xanthelasma and colonic xanthelasma redirect here.

Colorectal xanthomatous polyp may be abbreviated CXP.

General

  • Rare.[1]
  • May be associated with hyperlipidemia (7/25 patients in one series[2]).

Gross

  • Usually red colour.[2]
    • Classically described as yellow.[1][2]

Microscopic

Features:

  • Abundant foamy histiocytes in the superficial lamina propria.
  • +/-Superficial serrations (hyperplastic features).
    • Seen in ~80% of cases.[2]

DDx:

Images

  • XP - very low mag.

  • XP - low mag.

  • XP - intermed. mag.

  • XP - intermed. mag.

  • XP - high mag.

  • XP - very high mag.

  • XP - very high mag.

Stains

IHC

  • CD68 +ve (foamy histiocytes).[1]
  • Pankeratin -ve.

Sign out

Polyp, Rectum, Polypectomy or Biopsy:
- Xanthomatous polyp with hyperplastic features, see comment.
- NEGATIVE for dysplasia.

COMMENT:
Xanthomatous polyps may be seen in the context of hyperlipidemia.[1]  A lipid 
profile could be considered.

1. APMIS 112 (1): 3-10. PMID: 14961968.

Block letters

POLYP, SIGMOID COLON, POLYPECTOMY:
- XANTHOMATOUS POLYP WITH HYPERPLASTIC FEATURES.
- NEGATIVE FOR DYSPLASIA.

COMMENT:
Xanthomatous polyps may be seen in the context of hyperlipidemia.[1]  A lipid 
profile could be considered.

1. APMIS 112 (1): 3-10. PMID: 14961968.

See also

References

  1. ↑ 1.0 1.1 1.2 Miliauskas, JR. (Apr 2002). "Rectosigmoid (colonic) xanthoma: a report of four cases and review of the literature.". Pathology 34 (2): 144-7. PMID 12009096.
  2. ↑ 2.0 2.1 2.2 2.3 Nakasono, M.; Hirokawa, M.; Muguruma, N.; Okahisa, T.; Okamura, S.; Ito, S.; Miyamoto, H.; Wada, S. et al. (Jan 2004). "Colorectal xanthomas with polypoid lesion: report of 25 cases.". APMIS 112 (1): 3-10. PMID 14961968.
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