Inflammatory Polyps

 Historically, these lesions have poorly defined histologic criteria and have been referred to by variety of names (e.g., fibroinflammatory polyp, fibroepithelial polyp, mucosal hyperplasia)






Etiology/Pathogenesis




• Probable result of mucosal injury


Clinical Issues




• Usually asymptomatic
image Often incidental finding at time of cholecystectomy

• Represent 15% of all benign gallbladder polyps

• Benign lesions with no malignant potential


Imaging




• May be difficult to distinguish from gallstones or malignancy


Macroscopic




• Usually solitary, sessile, red-gray or brown mucosal projections

• Typically range from 3-15 mm


Microscopic




• Inflamed, edematous stroma
• Acute and chronic inflammation and granulation tissue

• Epithelium may show reactive changes or be denuded

• Clusters of pyloric-type glands may be present

image Should not be misinterpreted as evidence of pyloric-type intracholecystic papillary/tubular neoplasm

image
Ulceration and Granulation Tissue
An inflammatory polyp of the gallbladder shows mucosal ulceration and granulation tissue, as well as stromal inflammation and foci of mucosa with pyloric-type metaplasia image .


image
Inflammation and Granulation Tissue
Inflammatory polyps of the gallbladder are usually secondary to inflammatory processes and thus are composed of inflammation and a proliferation of organizing granulation tissue.

image
Stromal Edema
This inflammatory/reactive mucosal polyp shows stromal edema with overlying benign gallbladder epithelium.

image
Pyloric Metaplasia
Many inflammatory/reactive gallbladder polyps contain foci of pyloric metaplasia image, which should not be misinterpreted as evidence of a pyloric-type intracholecystic papillary/tubular neoplasm. Note the surrounding inflammation and stromal edema.


TERMINOLOGY


Synonyms




• Fibroinflammatory polyp

• Fibroepithelial polyp

• Granulation tissue polyp

• Mucosal hyperplasia


Definitions




• Inflammatory mucosal lesion associated with underlying inflammatory process
image Poorly defined histologic criteria

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

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