Surgical Pathology Criteria

Cronkhite-Canada Syndrome

Differential Diagnosis

Cronkhite-Canada Syndrome Juvenile Polyposis
Most colorectal polyps sessile Most colorectal polyps polypoid
Hair, nail, skin changes present No associated ectodermal changes
No dysplasia Infrequent cases may have focal dysplasia
Not familial Autosomal dominant, 75% are new mutations without family history
The gastrointestinal polyps are largely indistinguishable

 

Cronkhite-Canada Syndrome Cowden Disease
Hair, nail, skin pigmentation changes present Most have facial mucocutaneous lesions, see description
No association with breast hamartomas or carcinomas Frequent breast hamartomas and carcinomas
No association with thyroid carcinomas Frequent thyroid carcinomas
PTEN mutations not seen PTEN mutations in 80%
Not familial Autosomal dominant (half are new mutations without family history)
The gastrointestinal polyps are largely indistinguishable

 

Cronkhite-Canada Syndrome Peutz-Jeghers Syndrome
May have facial pigmented macules but no mucosal involvement described Mucocutaneous hyperpigmentation
Hair, nail, skin pigmentation changes present Internal neoplasms and non-GI polyps may occur
Smooth muscle absent or only small amounts in lamina propria Prominent arborizing smooth muscle bundles in GI polyps
Frequent mucous retention cysts Lacks retention cysts
Lacks pseudoinvasion May have displaced mucosa with pseudoinvasion of underlying muscularis propria
Not familial Autosomal dominant

 

Cronkhite-Canada Syndrome Hereditary Mixed Polyposis Syndrome
Usually >50 polyps Usually 1-15 polyps, rarely >50
Adenomas infrequent (sporadic adenomas may occur) Adenomas common
Hair, nail, skin pigmentation changes present No associated extra-GI lesions
Not familial Autosomal dominant
The polyps in some cases are indistinguishable

 

Cronkhite-Canada Syndrome, Gastric Involvement Hyperplastic Polyps of the Stomach
Usually >50 polyps Usually solitary
Hair, nail, skin pigmentation changes present No associated extra-GI lesions
Colorectal polyps very common Not associated with colorectal polyps
The polyps in some cases are indistinguishable

 

Cronkhite-Canada Syndrome, Gastric Involvement Menetrier Disease
Hair, nail, skin pigmentation changes present No associated extra-GI lesions
Colorectal polyps very common Not associated with colorectal polyps
On biopsy, the polyps and polypoid mucosa in some cases are indistinguishable and both are associated with protein losing enteropathy

Stanford Medicine Resources:

Footer Links: