Non-familial juvenile polyposis with histological evidence of adenomatous transformation.
A 14-year-old male presented with abdominal pain, diarrhoea and a sensation of something prolapsing through the anus during defecation, and was found to have diffuse colonic polyposis. There was no evidence of mucocutaneous hyperpigmentation and family history was negative, suggesting a diagnosis of non-familial juvenile polyposis. Histological analysis of multiple endoscopic biopsies showed features typical of juvenile or retention type (hamartomatous) lesions: dilated cystic glands lined by mucocus-secreting epithelium and prominent, inflamed and congested lamina propria. However, admixed with these features, focal areas of atypical adenomatous changes were recognized. Even the intervening normal-looking colonic mucosa showed some dysplastic changes. These findings indicate that hamartomatous and atypical adenomatous epithelial changes can co exist in non-familial juvenile polyposis and the latter may confer a risk of malignant transformation in this otherwise non-neoplastic disease.
Chakraborty
Praloy
P
Department of Medicine, Lok Nayak Hospital, New Delhi.
Shakuja
P
P
Kundra
A
A
Jain
Anil
A
Singh
Shivendra
S
Anuradha
S
S
Agarwal
Anil
A
Kar
Premashish
P
D018256:Adenomatous Polyps / Q000473:pathology*; D000293:Adolescent; D002471:Cell Transformation, Neoplastic; D003110:Colonic Neoplasms / Q000473:pathology*; D006222:Hamartoma / Q000473:pathology*; D006801:Humans; D007194:India; D044483:Intestinal Polyposis / Q000473:pathology*; D008297:Male