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Anus and perianal area

Benign or non-neoplastic lesions

Hypertrophied papillae

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 15 April 2013, last major update April 2005
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.


● Also called anal skin tags, fibroepithelial polyps
● Common; due to edema, inflammation, fibrosis
● Protrude into anal canal, adjacent to anal ulcers
● Benign; may be reactive hyperplasia of connective tissue

Gross description

● Polypoid, may resemble hemorrhoids

Micro description

● Projections of submucosa and overlying mucosa
● Squamous epithelium with central core of inflamed, edematous, myxoid or fibrovascular stroma with thin walled vessels
● 80% have large, multinucleated, CD34+ stellate cells, often with atypical nuclear features
● Frequent mast cells
● No thick walled vessels, no organizing thrombi, no hemorrhage
● Characterized by presence of mononucleated and multinucleated, sometimes atypical stromal cells showing fibroblastic and myofibroblastic differentiation (Am J Surg Pathol 1998;22:70)

Electron microscopy description

● Fibroblastic and myofibroblastic stromal cells

End of Anus and perianal area > Benign or non-neoplastic lesions > Hypertrophied papillae

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