Hyperplastic Polyps

 Usually in context of inflammatory process


image Reportedly 2nd most common type of gallbladder polyp


• Metaplastic polyp, mucosal hyperplasia, inflammatory polyp, localized papillary hyperplasia

• Historically, a.k.a. metaplastic polyp, mucosal hyperplasia, inflammatory polyp, or localized papillary hyperplasia
image Poorly defined diagnostic criteria and often used interchangeably




Etiology/Pathogenesis




• Most occur in setting of cholecystitis or cholelithiasis


Clinical Issues




• Usually incidental finding at time of cholecystectomy

• Benign with no risk of progression to dysplasia or malignancy

• Affects males and females with no age predilection


Macroscopic




• Small polyps, usually < 5 mm in diameter

• May be multiple and sessile or pedunculated


Microscopic




• Prominent hyperplastic mucosal folds and papillae
image Mucosa on surface resembles normal gallbladder epithelium

• Metaplastic changes are common
image Foveolar, pyloric, &/or intestinal types

• May show focal inflammation, especially at surface

• Reactive epithelial changes may be confused with dysplasia

image
Papillary Folds and Stroma
Low-power view of a hyperplastic polyp of the gallbladder illustrates the prominent mucosal folds and papillae with abundant intervening stroma.


image
Benign Biliary Epithelium
H&E of a hyperplastic polyp at high power shows that the polyp surface is lined by normal-appearing gallbladder mucosa image .

image
Reactive Epithelial Changes
Reactive epithelial changes in a hyperplastic polyp include vesicular nuclei and prominent nucleoli image associated with inflammation.

image
Intestinal Metaplasia
Metaplastic changes are very common in hyperplastic polyps. This section shows intestinal-type metaplasia with many goblet cells.


TERMINOLOGY


Abbreviations




• Hyperplastic polyp (HP)


Synonyms




• Metaplastic polyp, mucosal hyperplasia, inflammatory polyp, localized papillary hyperplasia
image Poorly defined diagnostic criteria and often used interchangeably

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Apr 20, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Hyperplastic Polyps

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