Surgical Pathology Criteria

Juvenile Polyp of the Gastrointestinal Tract

Differential Diagnosis

Sporadic Juvenile Polyp Hyperplastic Polyp
Prominent cystically dilated glands Cystic dilation not prominent
Irregular glands Glands are vertically arranged and not complex

 

Mucosal Prolapse / Cloacogenic Polyp Sporadic Juvenile Polyp
Surface erosions with granulation tissue frequent Surface erosions infrequent
Irregular glands with scattered dilation Prominent, regularly dilated glands
Smooth muscle extension into lamina propria of polyps No smooth muscle in lamina propria of polyps
Restricted to rectum (rarely in sigmoid) May involve any part of colorectum

 

Sporadic Juvenile Polyp Reactive / Inflammatory Polyp
Prominent cystically dilated glands May have irregular dilation but not typically prominent and regular
Common in children without other GI disease More common in inflammatory bowel disease and diverticulitis but may be sporadic
The two can be similar in areas

 

Sporadic Juvenile Polyp Tubular Adenoma
Lacks cytologic dysplasia Requires cytologic dysplasia
Prominent cystically dilated glands Cystic dilation usually not prominent
Abundant inflamed stroma Inflamed stroma usually not prominent

 

Solitary Juvenile Polyp Solitary Peutz-Jeghers Type Hamartomatous Polyp
Smooth muscle absent in lamina propria Prominent arborizing smooth muscle bundles
Frequent mucous retention cysts Lacks retention cysts
Lacks pseudoinvasion May have displaced mucosa with pseudoinvasion of underlying muscularis propria

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