Inverted lymphoglandular polyp in descending colon

Area of Science:

• Gastroenterology
• Surgical Pathology
• Oncology

Background:

• A 47-year-old male with a history of left colon cancer presented with rectal bleeding.
• A sessile polyp was detected in the proximal descending colon during colonoscopy.

Purpose of the Study:

• To describe a rare colonic polyp with unique histological features.
• To raise awareness for the recognition of this unusual entity.

Main Methods:

• Colonoscopic examination and polypectomy.
• Histopathological analysis including immunohistochemical staining (CK20, CDX2, CK7).
• Literature review for similar reported cases.

Main Results:

• Histology revealed a polyp with normal colonic mucosa, focal erosion, submucosal cystically dilated glands, and lymphoid aggregates.
• Immunohistochemistry showed glands positive for CK20 and CDX2, negative for CK7, with a low proliferative index, consistent with reactive colonic glands.
• The lesion was designated as an inverted lymphoglandular polyp, with no exact matches found in the literature.

Conclusions:

• The described lesion represents a rare histological entity, potentially termed inverted lymphoglandular polyp.
• Recognition of this polyp is important for accurate diagnosis and patient management.
• The patient remained asymptomatic one year post-polypectomy.