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# | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Peutz-Jeghers_syndrome_polyp.jpg | |||
| Width = | |||
| Caption = Peutz-Jeghers polyp. [[H&E stain]]. | |||
| Micro = polyp with branching ''or'' thickened muscularis mucosae, benign epithelium, and lamina propria | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = STK11 mutation | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[colon]], [[small bowel]], [[stomach]], others | |||
| Assdx = | |||
| Syndromes = [[Peutz-Jeghers syndrome]] | |||
| Clinicalhx = family history of cancer - esp. gastrointestinal and [[breast cancer|breast]] | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign lesion; suggests increased malignancy risk | |||
| Other = | |||
| ClinDDx = other [[gastrointestinal polyps]] | |||
}} | |||
{{ Infobox external links | |||
| Name = Peutz-Jeghers polyp | |||
| EHVSC = 10180 | |||
| pathprotocols = | |||
| wikipedia = | |||
| pathoutlines = | |||
}} | |||
'''Peutz-Jeghers polyp''', abbreviated '''PJP''', is an uncommon [[hamartoma|hamartomous]] [[gastrointestinal polyp]]. It is usually associated with [[Peutz-Jeghers syndrome]]. | |||
==General== | |||
===Epidemiology=== | |||
Features:<ref name=Ref_PBoD859>{{Ref PBoD|859}}</ref><ref name=pmid12692201>{{Cite journal | last1 = Bronner | first1 = MP. | title = Gastrointestinal inherited polyposis syndromes. | journal = Mod Pathol | volume = 16 | issue = 4 | pages = 359-65 | month = Apr | year = 2003 | doi = 10.1097/01.MP.0000062992.54036.E4 | PMID = 12692201 | url = http://www.nature.com/modpathol/journal/v16/n4/full/3880773a.html }}</ref> | |||
*[[Peutz-Jeghers syndrome]] is autosomal dominant. | |||
*Altered gene: STK11. | |||
===Clinical=== | |||
Features:<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/175200 http://www.ncbi.nlm.nih.gov/omim/175200]. Accessed on: 13 July 2010.</ref> | |||
*Melanocytic macules. | |||
**Lips, buccal mucosa, and digits. | |||
**Multiple Peutz-Jeghers polyps. | |||
Increased risk of various neoplasms - primarily: | |||
*Breast and gastrointestinal cancer.<ref name=pmid20581245>{{cite journal |author=Beggs AD, Latchford AR, Vasen HF, ''et al.'' |title=Peutz-Jeghers syndrome: a systematic review and recommendations for management |journal=Gut |volume=59 |issue=7 |pages=975–86 |year=2010 |month=July |pmid=20581245 |doi=10.1136/gut.2009.198499 |url=}}</ref> | |||
*Others tumours:<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/175200 http://www.ncbi.nlm.nih.gov/omim/175200]. Accessed on: 22 December 2010.</ref> | |||
**[[Granulosa cell tumour]]. | |||
**[[Sertoli cell tumour]] - esp. with calcification. | |||
==Microscopic== | |||
Features:<ref name=Ref_PBoD859/><ref name=pmid12692201>{{Cite journal | last1 = Bronner | first1 = MP. | title = Gastrointestinal inherited polyposis syndromes. | journal = Mod Pathol | volume = 16 | issue = 4 | pages = 359-65 | month = Apr | year = 2003 | doi = 10.1097/01.MP.0000062992.54036.E4 | PMID = 12692201 | url = http://www.nature.com/modpathol/journal/v16/n4/full/3880773a.html }}</ref> | |||
*Frond-like polyp with all three components of mucosa: | |||
*# Muscosal epithelium (melanotic mucosa, goblet cells). | |||
*# Lamina propria. | |||
*# M. mucosae. | |||
Notes: | |||
*''Frond'' = leaflike expansion.<ref>URL: [http://dictionary.reference.com/browse/frond http://dictionary.reference.com/browse/frond]. Accessed on: 26 July 2011.</ref> | |||
**The '''key''' is "thick" smooth muscle bundles - if one is lucky one sees branching.<ref>C. Streutker. 26 July 2011.</ref> | |||
***"Thick" ~= thickness of muscularis mucosae. | |||
DDx: | |||
*[[Hyperplastic polyp of the stomach]] - should ''not'' have thickened muscle. | |||
**May be confused with PJP as branching may not be apparent. | |||
===Images=== | |||
<gallery> | |||
Image:Peutz-Jeghers_syndrome_polyp.jpg | Peutz-Jeghers polyp - intestine (WC/Nephron) | |||
</gallery> | |||
<gallery> | |||
Image:Gastric_Peutz-Jeghers_polyp_-_very_low_mag.jpg | Peutz-Jeghers polyp - stomach - very low mag. (WC/Nephron) | |||
Image: Gastric Peutz-Jeghers polyp - low mag.jpg | Peutz-Jeghers polyp - stomach - low mag. (WC/Nephron) | |||
Image: Gastric Peutz-Jeghers polyp - intermed mag.jpg | Peutz-Jeghers polyp - stomach - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
<gallery> | |||
Image:Colon histology with Peutz-Jeghers polyp.jpg | Peutz-Jeghers (colonic) polyp (WC) | |||
</gallery> | |||
==IHC== | |||
*[[Chromogranin A]] - increased staining in relation to background; increased enterochromaffin cells.<ref name=pmid24364221>{{Cite journal | last1 = Krstić | first1 = M. | last2 = Katić | first2 = V. | last3 = Stojnev | first3 = S. | last4 = Mihailović | first4 = D. | last5 = Mojsilović | first5 = M. | last6 = Radovanović | first6 = Z. | last7 = Zivković | first7 = V. | title = Peutz-Jeghers syndrome: quantitative study on enterochromaffin cells in hamartomatous intestine polyps. | journal = Srp Arh Celok Lek | volume = 141 | issue = 9-10 | pages = 602-7 | month = | year = | doi = | PMID = 24364221 }}</ref> | |||
==Sign out== | |||
===Duodenum=== | |||
<pre> | |||
POLYPS, DUODENUM, EXCISION: | |||
- PEUTZ-JEGHERS POLYPS (x2) WITH BRUNNER'S GLANDS. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Colon=== | |||
<pre> | |||
POLYP, COLON (40 CM), EXCISION: | |||
- PEUTZ-JEGHERS POLYP. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
==See also== | |||
*[[Gastrointestinal tract polyps]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] |
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