TITLE:
Colorectal Inflammatory Pseudopolyps: A Retrospective Analysis of 70 Patients
AUTHORS:
Ankit V. Gandhi, Sajjad M. Malik, Juan P. Palazzo
KEYWORDS:
Inflammatory Pseudopolyps, Non-Inflammatory Bowel Disease, Sporadic, Pathologies
JOURNAL NAME:
Open Journal of Pathology,
Vol.4 No.3,
July
14,
2014
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.