ABSTRACT
Pseudopolyp is a common association of ulcerative colitis but may also occur in Crohn's disease, ischemic colitis and infective colitis. Pseudopolyps are results of the repair process, representing islands of granulation tissue surrounded by mucosa with ulceation. When a pseudopolyp is larger than 1.5 cm, it is often called a "giant pseudopolyp". Such lesions of inflammatory origin are often confused with polypoid carcinoma or infiltrating submucosal malignancy. We report a case of asymptomatic Crohn's disease as giant pseudopolyposis mimicking malignancy on sigmoid colon, with a review of relevant literatures.
Subject(s)
Colitis , Colitis, Ischemic , Colitis, Ulcerative , Colon, Sigmoid , Crohn Disease , Fistula , Granulation Tissue , Islands , Mucous MembraneABSTRACT
Pseudopolyposis occurs twice as often in ulcerative colitis as in Crohn's disease. Pseudopolypsis is divided into the followings: localized multiple pseudopolyposis, localized giant pseudopolyposis, generalized pseudopolyposis and long finger-like pseudopolyps. The most serious problem is confusion with carcinoma. Indications for operation are intussusception or obstruction, radiological simulation of carcinoma. The pseudopolyp could be managed by careful follow-up with colonoscopy and multiple biopsies. We report a case of localized giant pseudopolyposis of the cecum associated with Crohn's disease, with review of relevant literature.
Subject(s)
Biopsy , Cecum , Colitis, Ulcerative , Colonoscopy , Crohn Disease , Follow-Up Studies , IntussusceptionABSTRACT
Pseudopolyps represent discrete areas of mucosal inflammation and regeneration that are seen in a variety of inflammatory bowel disease including ulcerative colitis and Crohn's disease. These polyps are typically short, measuring less than 1.5 cm in height. Rarely, localized giant pseudopolyposis can occur, i.e., a collection of larger inflammatory pseudopolyps giving rise to a mass lesion within the colon. The most serious problem concerned with pseudopolyposis is a confusion with carcinoma. We experienced a case of localized giant pseudopolyposis causing partial large bowel obstruction. Right hemicolectomy was done for a preoperative diagnosis of ascending colon carcinoma. The resected specimen contained a circumferential lesion, which was composed of numerous interconnecting cylindrical villi, measuring 12 cm in length and 3 cm in height. Microscopically, these polypoid lesions were inflammatory pseudopolyps. Several deep fissure-like ulcerations were noted with multifocal microabscess, lymphoid hyperplasia and an area of noncaseating granuloma.