Sakamoto T, Kato H, Okabe T, Ohya T, Iesato H, Yokomori T, Haga S-S
Department of Clinical Laboratory, Tokyo Women's Medical University Daini Hospital, 2-1-10 Nishi-Ogu, Tokyo 116-8567, Japan.
Dig Liver Dis. 2005 Dec;37(12):968-72. doi: 10.1016/j.dld.2005.03.014. Epub 2005 Oct 19.
Inflammatory fibroid polyp is a rare benign polypoid lesion of the gastrointestinal tract. Histologically, inflammatory fibroid polyp is characterised by an admixture of numerous small vessels, fibroblasts and oedematous connective tissue, accompanied by marked inflammatory infiltration by eosinophils. A 40-year-old man visited our hospital for the purpose of colorectal screening due to a positive faecal occult blood test. A pedunculated and reddish polyp was found endoscopically in the ascending colon. The polyp was large but was resected endoscopically without any problems. Histologically, the abnormal tissue of the polyp was located in the submucosal and mucosal layer. Proliferation of spindle cells and infiltration of inflammatory cells, such as plasma cells and eosinophils, were observed. Immunohistochemically, the spindle cells were positive for CD34, which was localised in the cytoplasm. These cells were also positive for S100 protein but were negative for c-kit and muscle markers. These findings are compatible with the histological diagnosis of inflammatory fibroid polyp. The surgical margin of the polyp was free of the tumour. Inflammatory fibroid polyp is more commonly found in the stomach or small intestine, and rarely in the colon, and therefore our case is a rare example of large and pedunculated colonic inflammatory fibroid polyp, which was treated successfully by endoscopic polypectomy.
炎性纤维瘤性息肉是一种罕见的胃肠道良性息肉样病变。组织学上,炎性纤维瘤性息肉的特征是有大量小血管、成纤维细胞和水肿性结缔组织混合存在,并伴有明显的嗜酸性粒细胞炎性浸润。一名40岁男性因粪便潜血试验阳性前来我院进行结直肠筛查。内镜检查发现升结肠有一个带蒂的红色息肉。息肉较大,但在内镜下顺利切除。组织学检查显示,息肉的异常组织位于黏膜下层和黏膜层。观察到梭形细胞增生以及浆细胞和嗜酸性粒细胞等炎性细胞浸润。免疫组化显示,梭形细胞CD34阳性,定位于细胞质。这些细胞S100蛋白也呈阳性,但c-kit和肌肉标志物呈阴性。这些发现与炎性纤维瘤性息肉的组织学诊断相符。息肉的手术切缘无肿瘤。炎性纤维瘤性息肉更常见于胃或小肠,很少见于结肠,因此我们的病例是一例罕见的带蒂大的结肠炎性纤维瘤性息肉,通过内镜下息肉切除术成功治疗。