Talk:Gastrointestinal tract polyps

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Peutz-Jeghers polyp

Microscopic

Sections show a Peutz-Jeghers polyp with an arborizing smooth muscle pattern. The lamina propria ratio is normal. There is no dysplasia.

Final diagnosis

Gastric polyp, antrum, resection - Peutz-Jeghers polyp.

Juvenile polyp

Microscopic description

The sections show a polyp on a short stalk with focal mucosal ulceration, a moderately expanded inflamed lamina propria and moderate focal dilation of the glands. There is no dysplasia.

Final diagnosis

Polyp, ascending colon, polypectomy - Juvenile polyp.

Juvenile polyp vs. solitary rectal ulcer

Microscopic description

The section shows benign goblet cell-rich colonic-type mucosa adjacent to a vascular polypoid lesion with a dense inflammatory infiltrate (consisting of plasma cells, lymphocytes and eosinophils). There are two large dilated glands within the polypoid lesion. No surface epithelium covers the polypoid lesion. Benign bone is seen at the base of the lesion, adjacent to normal colonic-type mucosa.

Final diagnosis

Polyp, rectum, biopsy - Benign pseudopolyp with dense inflammatory infiltrate and dilated glands, favour juvenile polyp, see comment.

Comment

The histomorphologic features in this specimen are those of a benign, chronic process; however, they are not distinctive. They are compatible with (1) a juvenile polyp, (2) a polypoid solitary rectal ulcer, and (3) an inflammatory pseudopolyp. As an inflammatory pseudopolyp is in the pathologic differential diagnosis, inflammatory bowel disease should be considered clinically.

Tubular adenoma - low-grade dysplasia

Microscopic description

The sections show normal colonic-type mucosa and abnormal mucosal glands that have, from crypt base to luminal aspect, nuclear pseudostratification/crowding, nuclear hyperchromasia and enlargement, goblet cell paucity, and cytoplasmic hyperchromasia.

The abnormal nuclei maintain basal stratification. There is no definite cribriforming of glands, and no sheeting of the atypical epithelium. No lamina propria invasion is identified.

Final diagnosis

Polyp, transverse colon, excision - tubular adenoma, negative for high-grade dysplasia, see comment.

Comment

Completeness of excision is best assessed endoscopically.

Irritated polypoid fragment

POLYP, DESCENDING COLON, BIOPSY:
- INFLAMED POLYPOID FRAGMENT OF COLORECTAL-TYPE MUCOSA.
-- NEGATIVE FOR DYSPLASIA.