Difference between revisions of "Colorectal xanthomatous polyp"

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The '''colorectal xanthomatous polyp''' is a rare benign [[intestinal polyp]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Xanthomatous polyp -- intermed mag.jpg
| Width      =
| Caption    = Colorectal xanthomatous polyp. [[H&E stain]].
| Synonyms  =
| Micro      = abundant foamy histiocytes in the superficial lamina propria +/- superficial serrations (hyperplastic features)
| Subtypes  =
| LMDDx      = [[hyperplastic polyp]], [[signet ring cell carcinoma]], others
| Stains    =
| IHC        = CD68 +ve, pankeratin -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[colon]], [[rectum]]
| Assdx      = +/-hyperlipidemia
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  = polyp - red or yellow colour
| Prognosis  = benign
| Other      =
| ClinDDx    = other [[colorectal polyps]]
| Tx        =
}}
The '''colorectal xanthomatous polyp''', also '''colorectal xanthoma''', is a rare benign [[intestinal polyp]].
 
'''Rectal xanthoma''', '''colonic xanthoma''', '''rectal xanthelasma''' and '''colonic xanthelasma''' redirect here.
 
''Colorectal xanthomatous polyp'' may be abbreviated '''CXP'''.


==General==
==General==
*Rare.
*Rare.<ref name=pmid12009096>{{Cite journal  | last1 = Miliauskas | first1 = JR. | title = Rectosigmoid (colonic) xanthoma: a report of four cases and review of the literature. | journal = Pathology | volume = 34 | issue = 2 | pages = 144-7 | month = Apr | year = 2002 | doi =  | PMID = 12009096 }}</ref>
*May be associated with hyperlipidemia (7/25 patients in one series<ref name=pmid14961968>{{Cite journal  | last1 = Nakasono | first1 = M. | last2 = Hirokawa | first2 = M. | last3 = Muguruma | first3 = N. | last4 = Okahisa | first4 = T. | last5 = Okamura | first5 = S. | last6 = Ito | first6 = S. | last7 = Miyamoto | first7 = H. | last8 = Wada | first8 = S. | last9 = Fukuda | first9 = T. | title = Colorectal xanthomas with polypoid lesion: report of 25 cases. | journal = APMIS | volume = 112 | issue = 1 | pages = 3-10 | month = Jan | year = 2004 | doi =  | PMID = 14961968 }}</ref>).
*May be associated with hyperlipidemia (7/25 patients in one series<ref name=pmid14961968>{{Cite journal  | last1 = Nakasono | first1 = M. | last2 = Hirokawa | first2 = M. | last3 = Muguruma | first3 = N. | last4 = Okahisa | first4 = T. | last5 = Okamura | first5 = S. | last6 = Ito | first6 = S. | last7 = Miyamoto | first7 = H. | last8 = Wada | first8 = S. | last9 = Fukuda | first9 = T. | title = Colorectal xanthomas with polypoid lesion: report of 25 cases. | journal = APMIS | volume = 112 | issue = 1 | pages = 3-10 | month = Jan | year = 2004 | doi =  | PMID = 14961968 }}</ref>).
==Gross==
*Usually red colour.<ref name=pmid14961968/>
**Classically described as ''yellow''.<ref name=pmid12009096/><ref name=pmid14961968/>


==Microscopic==
==Microscopic==
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DDx:
DDx:
*[[Hyperplastic polyp of the colon]].
*[[Hyperplastic polyp of the colon|Hyperplastic polyp]].
*[[Signet ring cell carcinoma]].
*[[Signet ring cell carcinoma]].
*[[Whipple disease]].
*[[Mycobacterium avium complex]].
===Images===
<gallery>
Image: Xanthomatous polyp -- very low mag.jpg | XP - very low mag.
Image: Xanthomatous polyp -- low mag.jpg | XP - low mag.
Image: Xanthomatous polyp -- intermed mag.jpg | XP - intermed. mag.
Image: Xanthomatous polyp - alt -- intermed mag.jpg | XP - intermed. mag.
Image: Xanthomatous polyp -- high mag.jpg | XP - high mag.
Image: Xanthomatous polyp -- very high mag.jpg | XP - very high mag.
Image: Xanthomatous polyp - a2 -- very high mag.jpg | XP - very high mag.
</gallery>
==Stains==
*[[ZN stain]] -ve.
*[[PAS stain]] -ve.
==IHC==
*CD68 +ve (foamy histiocytes).<ref name=pmid12009096/>
*Pankeratin -ve.


==Sign out==
==Sign out==
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COMMENT:
COMMENT:
Xanthomatous polyps may be seen in the context of hyperlipidemia.
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.
</pre>
</pre>


==See also==
==See also==
*[[Intestinal polyps]].
*[[Intestinal polyps]].
*[[Gastric xanthoma]].
*[[Urinary bladder xanthoma]].


==References==
==References==

Revision as of 16:24, 22 July 2015

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

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

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

Stains

IHC

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

Sign out

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.