Inverted lymphoglandular polyp in descending colon

Case Reports in Pathology
Shengmei ZhouParakrama Chandrasoma

Abstract

A 47-year-old male with a history of left colon cancer, status post left colon resection for 12 years, presented with rectal bleeding. Colonoscopic examination revealed an 8 mm sessile polyp in the proximal descending colon. Microscopic examination showed that the surface of this polyp was covered with a layer of normal colonic mucosa with focal surface erosion. In the submucosal layer, an intimate admixture of multiple cystically dilated glands and prominent lymphoid aggregates with germinal centers was seen. The glands were lined by columnar epithelium. Immunohistochemical staining showed the glands were positive for CK20 and CDX2 and negative for CK7, with a low proliferative index, mostly consistent with reactive colonic glands. The patient remained asymptomatic after one-year follow-up. A review of the literature shows very rare descriptions of similar lesions, but none fits exactly this pattern. We would designate this inverted lymphoglandular polyp and present this case to raise the awareness of recognizing this unusual histological entity.

References

Mar 1, 1976·Journal of Clinical Pathology·W F Kealy
Nov 1, 1989·Diseases of the Colon and Rectum·C B Guest, R K Reznick
Mar 1, 1986·Histopathology·A D O'Leary, E C Sweeney
Jun 1, 1981·The American Journal of Surgical Pathology·J G Magidson, K J Lewin
Sep 15, 2001·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·R K YantissR D Odze
Jul 2, 2005·Diseases of the Colon and Rectum·Satoru TamuraToshiaki Moriki

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Citations

Jan 29, 2020·Journal of Pathology and Translational Medicine·Yo Han JeonHee Kyung Chang
Apr 16, 2019·World Journal of Gastrointestinal Oncology·Aoife J McCarthy, Runjan Chetty

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