Libânio Diogo, Meireles Catarina, Afonso Luís Pedro, Henrique Rui, Pimentel-Nunes Pedro, Dinis-Ribeiro Mário
Gastroenterology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal.
Pathology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal.
GE Port J Gastroenterol. 2016 Feb 18;23(4):214-217. doi: 10.1016/j.jpge.2015.12.009. eCollection 2016 Jul-Aug.
Mucosal prolapse polyps (MPPs) are rare inflammatory lesions that are part of the mucosal prolapse syndrome. We present the case of a 40-year-old male with history of constipation referred to our institution with suspected rectal malignancy due to hematochezia and a palpable rectal mass. Colonoscopy revealed a 25 mm wide lesion suggestive of subepithelial origin but with marked erythema and erosion in the mucosa. Crypt dilatation and distortion, mixed inflammatory infiltrate and fibrosis were apparent on histological evaluation after bite-on-bite biopsies. Due to the initial suspicion of malignancy, resection was decided after discussion with the patient. However, due to non-elevation partial resection was performed allowing the diagnosis of MPP. Hematochezia ceased after obstipation treatment and endoscopic follow-up showed maintenance of the lesion with the same characteristics except for reduced dimension. MPP may mimic neoplastic lesions and should be considered in the differential diagnosis of rectal masses. History, endoscopy and histological characteristics are all necessary and important in the diagnosis of MPP.
黏膜脱垂息肉（MPP）是一种罕见的炎症性病变，是黏膜脱垂综合征的一部分。我们报告了一例40岁男性病例，该患者有便秘病史，因便血和可触及的直肠肿块被转诊至我院，怀疑患有直肠恶性肿瘤。结肠镜检查发现一个25毫米宽的病变，提示起源于上皮下，但黏膜有明显的红斑和糜烂。在逐块活检后的组织学评估中，可见隐窝扩张和变形、混合性炎性浸润及纤维化。由于最初怀疑为恶性肿瘤，经与患者讨论后决定进行切除。然而，由于无法抬举，故进行了局部切除，最终诊断为MPP。便秘治疗后便血停止，内镜随访显示病变维持原状，除尺寸缩小外，特征相同。MPP可能酷似肿瘤性病变，在直肠肿块的鉴别诊断中应予以考虑。病史、内镜检查和组织学特征在MPP的诊断中均必不可少且至关重要。
