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Colorectal Inflammatory Pseudopolyps: A Retrospective Analysis of 70 Patients

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DOI: 10.4236/ojpathology.2014.43015    4,536 Downloads   5,266 Views   Citations

ABSTRACT

Introduction: Inflammatory pseudopolyps (IPs) are a well-recognized entity in patients with inflammatory bowel disease (IBD), most likely developing from long-standing chronic inflammation. Similarly, IPs have been associated with ischemic and infectious colitis, intestinal ulcers, and mucosal anastomoses. This study aimed to analyze inflammatory pseudopolyps without a history of these known associated pathologies. Materials and Methods: A database search was conducted for patients who underwent biopsies at Thomas Jefferson University Hospital from 2003-2013 for the presence of colorectal IPs. Exclusion criteria consisted of patients with a history of IBD, mucosal anastomoses, ischemic and infectious colitis. Spatial and temporal associations between colonic pathologies and IPs were assessed via Fisher’s exact and chi-square test, respectively. Results: Seventy-five polyps from 70 patients fulfilled the database search criteria. Forty-one pseudopolyps (55%) arose from the rectosigmoid region. Twenty-two patients had no associated colon pathology (31%); 35 patients had epithelial polyps (50%), such as tubular adenomas, serrated adenomas, and hyperplastic polyps; 10 patients had colonic adenocarcinoma (16%), and 18 patients had diverticulosis (26%). Epithelial polyps were significantly associated with IPs in the same region. However, diverticulosis was independent of IPs in regard to space and time. Conclusion: Colorectal inflammatory pseudopolyps may develop sporadically in up to one third of the cases while others frequently arise in the background of non-IBD colonic pathology. The increased presence of these polyps in the left colon raises the possibility that a subset of them may arise in predisposed mucosa. These polyps need to be differentiated from other morphologically similar colonic polyps.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Gandhi, A. , Malik, S. and Palazzo, J. (2014) Colorectal Inflammatory Pseudopolyps: A Retrospective Analysis of 70 Patients. Open Journal of Pathology, 4, 94-100. doi: 10.4236/ojpathology.2014.43015.

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