PMC2828397_01
Endoscopic view. Colonoscopy showing a red, sessile and lobulated polyp in the cecum. A biopsy is performed.
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F1
A colonoscopy identified the presence of a spherical, sessile, lobulated polyp of the cecum, 4.2 cm in diameter, with a red and not bleeding but partially ulcerated surface (figure 1).
Surgical specimen: ileocecal resection. Surgical specimen: ileocecal resection. IMGP appears to be a spherical, sessile and lobulated polyp of the cecum, without a peduncle, 4.2 cm in diameter. An arrow shows a little adenomatous polyp below the IMGP next to the ileocecal valve.
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F2
Considering the chronic anemia and the polyp's features (absence of a peduncle and size), we decided to perform an ileocecal resection with a latero-lateral ileocolic anastomosis (figure 2).
Histological findings. Polyp's whole picture, showing cystic dilatations embedded in the fibromuscular stroma (A). Low power view of inflammatory granulation tissue and engorged capillaries in the lamina propria, hyperplastic glands with cystic dilatations and proliferation of smooth muscle from muscolaris mucosae (B, C). Diffuse positive immunostaining of smooth muscle actin (D). (A, B, C: hematossilin-eosin staining, A 1:1, B 2,5x obj, C 4x obj; D: anti-actin immunoperoxidase, 4x obj).
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F3
The histological examination of the polyp revealed inflammatory granulation tissue and engorged capillaries in the lamina propria, hyperplastic glands with cystic dilatations, proliferation of smooth muscle and multiple erosions on the polyp surface (figure 3).