J Pathol Transl Med.  2016 Nov;50(6):474-478. 10.4132/jptm.2016.04.27.

A Case of Giant Colonic Muco-submucosal Elongated Polyps Associated with Intussusception

• Kim JH
• Lee SY
• Jang JH
• Han HY
• Kang DW

• KMID: 2361996
• DOI: http://doi.org/10.4132/jptm.2016.04.27

Abstract

Colonic muco-submucosal elongated polyp (CMSEP), a newly categorized non-neoplastic colorectal polyp, is a pedunculated and elongated polyp composed of normal mucosal and submucosal layers without any proper muscle layer. We herein report a giant variant of CMSEP associated with intussusception in the rectosigmoid colon, with a review of the literature. A 48-year-old woman underwent a laparoscopic low anterior resection due to multiple large submucosal polypoid masses associated with intussusception. Grossly, the colonic masses were multiple pedunculated polyps with a long stalk and branches ranging in size from a few millimeters to 14.0 cm in length. Microscopically, there was no evidence of hyperplasia, atypia, or active inflammation in the mucosa. The submucosal layers were composed of edematous and fibrotic stroma with fat tissue, dilated vessels, and lymphoid follicles.

Keyword

Non-neoplastic colorectal polyps; Colonic muco-submucosal elongated polyp; Intussusception

MeSH Terms

Colon*
Female
Humans
Hyperplasia
Inflammation
Intussusception*
Middle Aged
Mucous Membrane
Polyps*

Figure

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  Fig. 1. Barium enema (A) and abdominal computed tomography (B) of colonic muco-submucosal elongated polyp reveal prominent mucosal and submucosal folds (arrow) associated with intussusception (asterisk) in rectosigmoid colon.

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  Fig. 2. Colonoscopy, gross and microscopic findings of colonic muco-submucosal elongated polyp. (A) Colonoscopy reveals multiple, large, movable, pedunculated, and sessile polyps from descending to sigmoid colon. (B) The polypoid masses show large, tree-like branching mucosal folds with elongated and pedunculated stalks with a broad base. (C) The polyps have long, elongated, and loose submucosal elongated stalks without cytological atypia and active inflammation. (D) α-Smooth muscle actin immunohistochemical stain show prominent smooth muscle of the muscularis mucosae.

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