Fibroepithelial Stromal Polyp
Elizabeth A. Montgomery, MD
Key Facts
Clinical Issues
Polypoid lesions presenting in vagina or vulva
Possible relationship to hormonal factors
Simple excision; occasional recurrences, especially with subsequent pregnancies
Microscopic Pathology
Coating of unremarkable or hyperplastic squamous mucosa
No Grenz zone between lesion and overlying mucosa/skin
Spindle to stellate cells
Tapering cytoplasmic processes
Multinucleation and nuclear enlargement common
Multinucleate cell with wreath-like appearance
Fibrous, edematous, or myxoid stroma
Can be highly cellular, mimicking sarcomas (often in pregnancy)
 Fibroepithelial stromal polyps are typically edematous at low magnification, with overlying reactive epithelial changes. Note that the lesion abuts the overlying epithelium without a Grenz zone. |
 At high magnification, most fibroepithelial stromal polyps consist of bland-appearing stellate to spindle cells in an edematous background with scattered inflammatory cells  . |
TERMINOLOGY
Abbreviations
Fibroepithelial stromal polyp (FSP)
Synonyms
Cellular pseudosarcomatous fibroepithelial stromal polyp, pseudosarcoma botryoides
Definitions
Benign polyps, usually involving vagina of women of reproductive age, composed of fibroblastic cells in edematous stroma
CLINICAL ISSUES
Epidemiology
Incidence
Relatively common
Age
Reproductive years
Gender
Women
Presentation
Polypoid lesions presenting in vagina or vulva
Possible relationship to hormonal factors
Discovered in antenatal examinations
Some regress in puerperium
Association with hormone usage
Treatment
Simple excision
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