Hamartomatous Polyp Takashi Hisabe 1 , Yoshiaki Aomi 1 , Takashi Nagahama 1 , Yasuhiro Takaki 1 , Fumihito Hirai 1 , Kenshi Yao 1 , Toshiyuki Matsui 1 , Hiroshi Tanabe 2 , Akinori Iwashita 2 1Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 過誤腫 , 若年性ポリープ , Peutz-Jeghers型ポリープ , hamartomatous inverted polyp , 大腸 pp.1118-1128
Published Date 2013/7/25
DOI https://doi.org/10.11477/mf.1403113882
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 Hamartomatous polyps are comparatively rare non-tumorous lesions, and much about their pathology remains unknown. Differential diagnosis for these lesions is often difficult. Juvenile polyps occur most commonly in the rectum and sigmoid colon, and in many cases are pedunculated and bright red, with erosive detachment of the epithelium. The surface structure displays a wide range of sparse pit patterns, including open round, tubular, and asteroid pits. These lesions must be distinguished from inflammatory myoglandular polyps, but as the latter present with clinical symptoms and endoscopic findings resembling those of juvenile polyps, with the exception of the fact that they are not seen in children, differentiation is difficult. Peutz-Jeghers type polyps commonly occur in the sigmoid colon, and are red or white with a pedunculated or semi-pedunculated appearance. The surface structure displays a wide variety of pit patterns, including round, tubular, and asteroid patterns, with scattered small bud-like or gyrus-like pits with somewhat dilated glandular openings. These must be distinguished from adenomas, which frequently display a similar appearance under regular and magnified observation. Hamartomatous inverted polyps occur distal to the transverse colon, and are elevated lesions covered in normal mucosa that exhibit a pedunculated or submucosal tumor-like morphology. Under magnification they display a uniform, slightly dilated type I pit pattern. These must be differentiated from colonic muco-submucosal elongated polyps or legions, which exhibit a submucosal tumor- like morphology. We have reviewed the clinical profiles and endoscopic findings of hamartomatous polyps, including an investigation of cases we have treated ourselves, and practitioners must be aware that hamartomas may display a wide range of endoscopic appearances.

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