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Case 461 - Discussion

Uploaded: 2010-10-27, Updated: 2010-10-27

 

Juvenile (retetion) Polyp

  • Most common childhood polyp, usually children < 5 years, 80% in rectum.

  • Commonly presents with rectal bleeding.

  • Usually sporadic; rarely associated with juvenile polyposis syndrome.

  • Not neoplastic by themselves, but may be associated with dysplasia.

  • Gross: hamartomatous, large lesions with long (1-2 cm) stalks, red granular or glistening surface; may see cystic cavities.

  • Micro: granulation tissue and ulcer on the surface, cystically dilated glands filled with mucus, edematous and inflamed stroma; often hyperplastic changes; minimal epithelium or smooth muscle; no atypia; occasionally foreign-body giant cell reaction to ruptured glands.

  • Familial juvenile polyposis: autosomal dominant, SMAD4 gene mutation, no PTEN or BMPR1 mutation.