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Immunosuppression-related fibroproliferative polyps: a substantial subset of acquired pediatric mucocutaneous polyps
Briana C Gleason1, Sara O Vargas
1Department of Pathology, Children's Hospital and Harvard Medical School, Boston, MA, USA.
Insights
Immunosuppressed children may develop fibroepithelial polyps in various locations, similar to tongue lesions. This suggests immunosuppression could be a key factor in the development of these pediatric skin growths.
Area of Science:
- Pediatric Pathology
- Dermatology
- Genetics
Background:
- A specific type of fibroepithelial polyp on the tongue in immunosuppressed children has been linked to chromosomal abnormalities.
- Fibroepithelial polyps are common benign skin growths.
Purpose of the Study:
- To investigate if fibroepithelial polyps in non-tongue locations in children are also associated with immunosuppression.
- To explore a potential link between these polyps and previously described tongue lesions.
Main Methods:
- Retrospective review of pediatric fibroepithelial polyps from nonlingual sites.
- Analysis of patient medical history for immunosuppression status.
- Histopathological examination of polyp samples.
Main Results:
- Eight fibroepithelial polyps were identified in six immunosuppressed pediatric patients across various mucocutaneous sites.
- Histology was consistent with common fibroepithelial polyps (skin tags).
- One patient had a known deletion on chromosome 22q11.
Conclusions:
- Fibroepithelial polyps in nonlingual sites may occur in immunosuppressed children.
- Immunosuppression is a potential contributing factor to the development of these polyps.
- Further research may clarify the relationship with tongue polyps and chromosomal abnormalities.
Abstract:
A distinct group of fibroproliferative polyps of the tongue arising in immunosuppressed children and often associated with chromosomal breakpoints at chromosomes 9p34 or 22q11 was recently described. Based on this finding, we reviewed fibroepithelial polyps arising in nonlingual sites in the pediatric population to investigate a possible relationship with immunosuppression. We identified 8 fibroepithelial polyps arising in 6 immunosuppressed patients (4 males and 2 females, median age 17 years) in a wide range of mucocutaneous sites. Histologic features were identical to the common fibroepithelial polyp, or skin tag, with a variably collagenous fibrovascular core covered by unremarkable squamous epithelium. No viral cytopathic changes were identified in any case. Although cytogenetic studies were not performed on any of the biopsy material, 1 patient had a constitutional deletion of chromosome 22q11. We suggest that there may be a relationship between these polyps and the previously described tongue lesions and that immunosuppression may be an important factor in their pathogenesis.
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