Proctitis Cystica Profunda (PCP) is a benign lesion that may be mistaken for rectal carcinoma.
In PCP rectal mucosa is present in the rectal submucosa with formation of mucus pools. The displaced mucosa may remain connected to the surface epithelium as a small diverticulum or it may become detached by the chronic inflammatory response.
Clinical findings may include:
(1) blood in stool
(2) mucous in stool
(3) mucosal inflammation with edema, erythema and friability
(4) mucosa described as "lumpy bumpy"
(5) variable inflammatory polyps and/or mucosal erosions
(6) sequelae of chronic inflammation with fibrosis, scarring and focal ischemic change
The epithelium within the displaced mucosa may show reactive atypia. This change plus pools of mucus may be mistaken for colloid carcinoma, particularly if there is a mass lesion several centimeters in diameter.
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