A juvenile polyp may occur as a sporadic finding or with the Juvenile Polyposis Syndrome.
Classic pathologic features:
(1) spherical, lobulated and pedunculated
(2) surface erosions
(3) prominent stroma with edema and inflammatory cells
(4) cystically dilated glands lined by cuboidal to columnar epithelium with reactive changes
(5) low crypt density
A juvenile polyp from a patient with familial polyposis:
(1) villous (frond-like) surface
(2) less stroma
(3) fewer cystically dilated glands
(4) smaller glands with a proliferative columnar epithelium which may be hypermucinous
(5) high crypt density
Absence of SMAD4 protein on immunohistochemistry is seen in patients with a germline SMAD4 mutation.
To read more or access our algorithms and calculators, please log in or register.
Specialty: Gastroenterology
