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Fate and ultra-structural features of chicken skin mucosa around juvenile polyps
M A El-Hodhod1, A A Soliman, A M Hamdy
1Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. moshodhod@yahoo.com
Insights
Chicken skin mucosa (CSM) around juvenile polyps in children is a benign reaction. This mucosal change, characterized by thickened muscularis mucosae, resolves within a month after polyp removal.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
Background:
- Chicken skin mucosa (CSM) is frequently observed around juvenile polyps in children.
- The ultrastructural characteristics and post-polypectomy fate of CSM remain incompletely understood.
Purpose of the Study:
- To investigate the ultrastructural features of CSM.
- To compare CSM with polyp and normal mucosa histologically.
- To determine the outcome of CSM following polypectomy.
Main Methods:
- Histological comparison of CSM, polyp mucosa, and normal mucosa from 36 children.
- Evaluation of CSM resolution in 45 children undergoing follow-up colonoscopy after polypectomy.
Main Results:
- CSM exhibited significantly higher goblet cells and muscularis mucosae thickness compared to normal mucosa.
- Polyp mucosa showed higher inflammatory cell infiltrates than CSM.
- CSM largely resolved within one month post-polypectomy.
Conclusions:
- CSM is characterized by a thickened muscularis mucosae and increased goblet cells.
- The inflammatory reaction is most pronounced in polyp mucosa.
- CSM appears to be a benign, compensatory response to the mechanical influence of juvenile polyps, resolving after their removal.
Objective:
Chicken skin mucosa (CSM) is a common finding around juvenile polyps in children. Its ultrastructural features and fate after polypectomy are not yet clear. The aim was to study ultra-structural features and outcome of this CSM compared to that of the polyps and distant endoscopically normal mucosa.
Material And Methods:
From 240 children with juvenile polyps, 45 needed a second colonoscopy. Thirty six patients showing CSM represented the cohort of this study. One polyp only was studied in each patient. The histologic features of the CSM were compared to normal and polyp mucosa. The fate of CSM was evaluated in the second colonoscopy.
Results:
The mean numbers of intraepithelial lymphocytes, as well as lamina propria inflammatory cellular infiltrates were significantly higher in polyp mucosa than in CSM. Goblet cells were significantly higher in CSM compared to normal mucosa with marked depletion in the polyp mucosa. The muscularis mucosae thickness was significantly higher in CSM compared to polyps (p<0.0001) and both showed higher values than the normal mucosa. The CSM almost disappeared within a month period following polypectomy.
Conclusions:
The polyp showed the most intense mucosal inflammatory reaction. CSM with the unique thickening of muscularis mucosae especially around larger polyps almost disappeared after polypectomy. So these results suggest that CSM is a benign compensatory reaction induced by the mechanical effect of the polyp.
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