Solitary Peutz-Jeghers polyp harboring a focus of high-grade dysplasia in the colon: a case report and literature review.

Autor: Maeda T; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan. maeda.t@hirosaki-u.ac.jp.; Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Aomori, 036-8562, Japan. maeda.t@hirosaki-u.ac.jp.; Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, 030-8553, Japan. maeda.t@hirosaki-u.ac.jp., Yoshizawa T; Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Aomori, 036-8562, Japan., Oyama T; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan., Nakagawa S; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan., Murai Y; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan., Machida R; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan., Ishidoya N; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan., Sakamoto J; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan., Iwamura H; Department of Gastroenterology, Tsugaru General Hospital, Aomori, 037-0074, Japan., Sakuraba H; Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Aomori, 036-8562, Japan.
Jazyk: angličtina
Zdroj: Clinical journal of gastroenterology [Clin J Gastroenterol] 2024 Nov 13. Date of Electronic Publication: 2024 Nov 13.
DOI: 10.1007/s12328-024-02059-x
Abstrakt: A solitary Peutz-Jeghers (PJ) polyp is a rare hamartomatous lesion without an associated PJ syndrome. However, little is known regarding malignancy arising in solitary PJ polyps. Here, we report a case of a solitary colonic PJ polyp with focal dysplasia. A 45-year-old asymptomatic man underwent total colonoscopy following a positive fecal occult blood test. The patient had no history of mucocutaneous pigmentation or family history of PJ syndrome. A 20 mm erythematous pedunculated polyp was observed in the sigmoid colon. Magnified endoscopy revealed a tubular or branch-like pit pattern with localized areas of irregular pits. These findings were suggestive of colorectal adenoma with high-grade dysplasia, and endoscopic mucosal resection was performed. Histopathological examination revealed arborizing proliferation of hyperplastic epithelia with smooth muscle bundles. In addition, a small number of irregular crypts with high-grade dysplasia were observed in the hyperplastic epithelium. Based on these histological findings, we finally diagnosed the patient with a solitary colonic PJ polyp with high-grade dysplasia. The present case suggests that solitary colonic PJ polyps may harbor dysplastic changes and require pathological evaluation with en bloc resection of the polyps.
Competing Interests: Declarations Conflict of interest The authors declare that they have no conflict of interest. Human/animal rights All procedures were performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments. Informed consent Informed consent was obtained from the patient in the case report.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: