Giant pseudopolyposis in granulomatous colitis

Abstract

A case is described of an unusual combination of polypois and inflammatory bowel disease of a granulomatous type. A striking feature is the complexity of the polypoidal lesions. The relationship between these lesions and the granulomatous colitis which is probably a variant of Crohn's disease is discussed.

Giant Pseudopolyposis in Inflammatory Bowel Disease

“… 10 More than 70 cases of giant pseudopolyposis associated with inflammatory bowel disease have been reported. 2,4–7,10–42 The presence of pseudopolyps per se does not reflect the severity of the underlying inflammatory bowel disease and may be found in both active and quiescent phases of ulcerative colitis. 2 The reported duration of ulcerative colitis and Crohn’s colitis, in whom pseudopolyposis is found, ranges, respectively, from 1 month to 20 years (median, 5 years) 2,4,10–34 and 3 months to 37 years (median, 6 years).…”

“… 2 The reported duration of ulcerative colitis and Crohn’s colitis, in whom pseudopolyposis is found, ranges, respectively, from 1 month to 20 years (median, 5 years) 2,4,10–34 and 3 months to 37 years (median, 6 years). 4–7,15,17,20,25,29,35–42 Diagnostic problems may arise with the identification of a giant pseudopolyp in a patient with quiescent disease, particularly when the surrounding mucosa reveals minimal evidence of inflammatory bowel disease. 4 Diagnosis may then be confused with a large colonic tumour.…”

Poliposis inflamatoria gigante difusa

“…Existe controversia respecto de la asociación existente entre esta entidad y la colitis ulcerativa idiopática y la enfermedad de Crohn. Un estudio antiguo muestra una incidencia de colitis ulcerosa en el 55% de los pacientes que presentan una PIG 10 . Sin embargo, publicaciones más recientes señalan que cerca de los dos tercios de los pacientes con una PIG tienen una enfermedad de Crohn y sólo un tercio una colitis ulcerosa 3 .…”

“…Sin embargo, en algunos casos como el que se presenta, destaca la presencia de una masa abdominal o la aparición de complicaciones dadas por la presencia y el tamaño de los pólipos, tales como la intususcepción intestinal o la obstrucción intestinal mecánica 5,12 . La patogenia de los pólipos está relacionada con una regeneración exagerada con una proliferación hiperplástica de la mucosa remanente entre las úlceras 10 . Los hallazgos histológicos son semejantes a los encontrados en los pólipos infl amatorios, es decir, infi ltrado infl amatorio sobre la muscular de la mucosa, asociado a úlceras profundas e hiperplasia linfoide.…”

Giant inflammatory polyposis of the descending colon associated with a Crohn’s disease‐like colitis

“…Inflammatory polyps are found in 10–20% of patients with chronic ulcerative colitis, 2,10 but may also occur in some Crohn’s disease, 11–13 ischemic 14 and infective colitis 15 patients. Most inflammatory polyps are less than 1.5 cm in height; the arbitrary criterion of 1.5 cm or greater in height has been accepted for giant polyps or polyposis 5 .…”