Hyperplastic polyp with perineuromatous stroma

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Hyperplastic polyp with perineuromatous stroma
Diagnosis in short

Hyperplastic polyp with perineuromatous stroma. H&E stain.
Synonyms benign serrated colorectal fibroblastic polyps/intramucosal perineurioma, hybrid hyperplastic polyp/mucosal perineurioma
LM serrated epithelial cells (at the surface), perineuromatous stroma
LM DDx colonic ganglioneuroma, hyperplastic polyp
Site colon and rectum
Prevalence rare
Endoscopy polyp
Prognosis benign
Clin. DDx other types of colorectal polyps

Hyperplastic polyp with perineuromatous stroma, also known as benign serrated colorectal fibroblastic polyps/intramucosal perineurioma and hybrid hyperplastic polyp/mucosal perineurioma, is a benign colorectal polyp.

It may be referred to as perineurioma and fibroblastic polyp.[1]

General

  • Rare.
  • Benign.[2]

Microscopic

Features:

  • Serrated epithelial cells (at the surface of the gland) - key feature.
    • Serrated appearance = saw-tooth appearance, epithelium has jagged edge.
  • Perineuromatous stroma.

DDx:

Images

  • HP with PNS - very low mag.

  • HP with PNS - low mag.

  • HP with PNS - intermed. mag.

  • HP with PNS - intermed. mag.

  • HP with PNS - high mag.

  • HP with PNS - high mag.

  • HP with PNS - very high mag.

IHC

Features:[3]

  • Vimentin +ve.
  • SMA -ve.
  • Desmin -ve.
  • CD117 -ve.
  • S-100 -ve
  • EMA -ve.

Sign out

Polyp, Colon at 35 cm, Polypectomy or Biopsy:
     - Hyperplastic polyp with perineuromatous stroma.

Micro

The sections show a polypoid fragment of colonic-type serrated epithelium with small round glands at the deep aspect. Fibroblastic/perineuromatous type stroma is present and NSE NEGATIVE, S100 NEGATIVE and desmin NEGATIVE. The tissue is NEGATIVE for atypia and NEGATIVE for apparent proliferative activity.

See also

References

  1. ↑ Groisman GM, Polak-Charcon S (July 2008). "Fibroblastic polyp of the colon and colonic perineurioma: 2 names for a single entity?". Am J Surg Pathol 32 (7): 1088–94. doi:10.1097/PAS.0b013e318160df3f. PMID 18520438.
  2. ↑ Agaimy, A.; Stoehr, R.; Vieth, M.; Hartmann, A. (Nov 2010). "Benign serrated colorectal fibroblastic polyps/intramucosal perineuriomas are true mixed epithelial-stromal polyps (hybrid hyperplastic polyp/mucosal perineurioma) with frequent BRAF mutations.". Am J Surg Pathol 34 (11): 1663-71. doi:10.1097/PAS.0b013e3181f4a458. PMID 20962618.
  3. ↑ Eslami-Varzaneh F, Washington K, Robert ME, Kashgarian M, Goldblum JR, Jain D (March 2004). "Benign fibroblastic polyps of the colon: a histologic, immunohistochemical, and ultrastructural study". Am J Surg Pathol 28 (3): 374–8. doi:10.1097/00000478-200403000-00010. PMID 15104300.
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