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Polypoid prolapsing mucosal folds in diverticular disease
1Department of Pathology, University of Calgary, Alberta, Canada.
The American Journal of Surgical Pathology
|September 1, 1991
Summary
Redundant mucosal folds in sigmoid colon diverticular disease can appear as polyps. These changes may stem from venous congestion and muscle contractions, mimicking inflammatory bowel disease.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pathology
Background:
- Diverticular disease of the sigmoid colon is common.
- Associated mucosal abnormalities require further characterization.
Observation:
- Eight sigmoid colectomy specimens with diverticular disease exhibited redundant or polypoid mucosal folds.
- Lesions varied from swollen folds to broad-based, leaflike polyps, often in rows between diverticula.
Findings:
- Microscopic examination revealed vascular congestion, edema, hemorrhage, hemosiderin deposition, and inflammation.
- Polypoid lesions showed crypt changes, muscle upgrowth, and hyperplastic-metaplastic changes consistent with mucosal prolapse.
- Two cases presented with diffuse inflammation resembling inflammatory bowel disease.
Implications:
- These findings suggest a mechanism involving venous congestion and mucosal redundancy due to muscle spasm in diverticular disease.
- The observed changes can mimic other colonic pathologies, necessitating careful differential diagnosis.