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Published on: August 24, 2019
Colonic chicken skin mucosa: association with juvenile polyps in children
M J Nowicki1, C Subramony, P R Bishop
1Department of Pathology, University of Mississippi Medical Center, Jackson 39216, USA.
Insights
Chicken skin mucosa is common in children with juvenile polyps, often linked to larger rectosigmoid polyps. This finding likely results from minor mucosal trauma, not preneoplasia.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Pathology
Background:
- Chicken skin mucosa is an endoscopic finding associated with colonic neoplasms in adults.
- Its presence and significance in children with juvenile polyps are not well-established.
Purpose of the Study:
- To determine the prevalence, endoscopic features, and location of chicken skin mucosa in children with juvenile polyps.
- To propose a pathogenic mechanism for this finding.
Main Methods:
- Prospective evaluation of children undergoing colonoscopy and polypectomy for juvenile polyps.
- Assessment for chicken skin mucosa, polyp location, and size.
- Histopathological examination of chicken skin mucosa biopsies.
Main Results:
- Chicken skin mucosa was found in 73% of children and 43% of juvenile polyps.
- Polyps associated with chicken skin mucosa were larger and located in the rectosigmoid colon.
- Lipid-laden macrophages were present in all tested chicken skin mucosa samples.
Conclusions:
- Chicken skin mucosa is a common finding in pediatric juvenile polyps.
- The finding is likely due to local mucosal trauma.
- It is unlikely to be a preneoplastic lesion.
Objectives:
Chicken skin mucosa is a newly described endoscopic finding associated with colonic neoplasms in adults. Chicken skin mucosa was sought in children with juvenile polyps to determine the prevalence, endoscopic features, and location. An alternative theory is proposed for the pathogenic mechanism of this finding.
Methods:
Children having colonoscopy and polypectomy were prospectively evaluated for the presence of chicken skin mucosa. The location of the polyps was determined at colonoscopy; the size of removed polyps was measured during processing of samples in pathology. Biopsies from colonic chicken skin mucosa were stained with hematoxylin and eosin and mucicarmine.
Results:
Over a 1-yr period, 27 juvenile polyps were removed from 15 children at colonoscopy. Eleven of 15 children (73%) were found to have polyps with chicken skin mucosa; overall, 43% of the polyps had associated chicken skin mucosa. Chicken skin mucosa-positive polyps were larger than chicken skin mucosa-negative polyps and were only found in the rectosigmoid colon. Lipid-laden macrophages were found in all samples of chicken skin mucosa tested.
Conclusions:
Chicken skin mucosa is a common finding in children with juvenile polyps. It probably is the result of local mucosal trauma, rather than a preneoplastic lesion.
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