Inflammatory pseudopolyp

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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

Inflammatory pseudopolyp is a benign polypoid lesion usually seen in the context of inflammatory bowel disease.

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:

Images

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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.

Diverticular disease-associated

Polyp, Sigmoid Colon, Polypectomy:
- Colonic mucosa with ulceration, acute inflammation and granulation tissue.
- NEGATIVE for dysplasia.

Comment:
This may represent a polyp seen in the context of diverticular disease. Other 
considerations include ischemia, idiopathic inflammation and infections. 
Clinical correlation is suggested.

Block letters

 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

References

  1. Aust, DE.; Rüschoff, J. (Jul 2011). "[Polyps of the colorectum: non-neoplastic and non-hamartomatous].". Pathologe 32 (4): 297-302. doi:10.1007/s00292-011-1435-1. PMID 21607734.