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Inverted hyperplastic polyposis of the colon

N A Shepherd1

  • 1Department of Histopathology, Gloucestershire Royal Hospital.

Journal of Clinical Pathology
|January 1, 1993
PubMed
Summary

Inverted hyperplastic polyps are a distinct type of colon polyp found in the proximal colon. These polyps share features with regular hyperplastic polyps but may mimic other conditions.

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Histopathology·2008

Area of Science:

  • Gastroenterology
  • Colorectal Pathology
  • Surgical Pathology

Background:

  • Hyperplastic polyps are common colorectal lesions.
  • Inverted hyperplastic polyps (IHPs) are a rare variant.
  • Understanding IHPs is crucial for accurate diagnosis and management.

Observation:

  • Two cases of IHPs in middle-aged men with concurrent proximal colon adenocarcinoma.
  • IHPs presented as multiple polyps (12-18) in the ascending colon, measuring 0.4-2.5 cm.
  • Macroscopic features included apical positioning on mucosal folds, surface pitting, and mucus hypersecretion.

Findings:

  • Histological analysis revealed inverted and misplaced hyperplastic epithelium associated with lymphoglandular complexes.
  • IHPs exhibited identical histochemical and immunohistochemical features to regular hyperplastic polyps.
  • One polyp showed focal adenomatous change, suggesting very low neoplastic potential.

Implications:

  • IHPs are unusual, distinctive polyps of the proximal colon.
  • Their pathogenesis may involve epithelial misplacement through muscularis mucosae defects.
  • IHPs can mimic adenomas and carcinomas, necessitating careful histopathological evaluation.

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