RESUMO
Cap polyposis is a very rare clinical entity, with only few cases reported in the literature. It is a benign disease, characterized by inflammatory polyps of the gastrointestinal tract. A 35-year-old woman was referred to our Gastroenterology department due to rectal bleeding. Endoscopic examination revealed multiple polypoid lesions in the middle/lower rectum. Histology was compatible with cap polyposis. She underwent mucosectomy of the lesions, with clinical and endoscopic improvement. Clinical findings and therapeutic approach represent a challenge in this pathology.
RESUMO
Filiform polyposis (FP) is a morphologic variant of pseudopolyposis associated with inflammatory conditions of the gastrointestinal tract, namely, inflammatory bowel disease. Pediatric cases are uncommon in the literature. Here, we present a pediatric patient with FP arising from ulcerative colitis (UC). He initially presented at 7 years of age for an acute UC flare and was found to have classical pseudopolyposis. A follow-up colonoscopy at age 9 showed the evolution of classical pseudopolyposis to FP. The patient clinically improved with sulfasalazine monotherapy and remained in remission based on consistent pediatric ulcerative colitis activity index scores of zero and normal-range inflammatory markers. Repeat surveillance colonoscopy at age 14 showed persistent and diffuse FP in the background of healthy colonic mucosa. This case documents the development of FP from classical pseudopolyps in the setting of an asymptomatic patient in clinical remission.
RESUMO
INTRODUCTION: In this study, we identify the frequency of pseudopolyps (PPs) with normal histology and their association to surrounding tissue. METHODS: Patients were enrolled in a study identifying endoscopic characteristics of PPs (n = 29) or were collected as part of our IBD biobank (n = 16). Statistical analysis included Stata v.15.0. chi-square and Student t-test. RESULTS: A total of 45 patients with 117 PP biopsies were identified. More patients with healed PP were in endoscopic remission compared with those with inflammatory PP (82.6% vs 17.4%, respectively). CONCLUSION: This is the first study to find mucosal healing of PPs and its association with deep remission.
RESUMO
Giant inflammatory pseudopolyps are begnin lesions that have been described usually in patients with inflammatory bowel disease. Rarely, they have been reported in patient without any colonic disease. We report the case of a 40-old woman, without previous colonic pathology, who presented with rectal giant inflammatory pseudopolyps revealed by rectal bleeding.
Les pseudo-polypes inflammatoires géants sont des tumeurs bénignes du tube digestif. Ils ont principalement été décrits chez les malades atteints de maladie inflammatoire chronique de l'intestin. Exceptionnellement, ils ont été rapportés chez des patients n'ayant aucune pathologie digestive. Nous rapportons l'observation d'une patiente de 40 ans, présentant de multiples pseudo-polypes inflammatoires géants du rectum, en l'absence de toute autre pathologie colorectale, révélés par des rectorragies.