Small bowel (small intestine)
Benign tumors and tumor-like conditions
Peutz-Jeghers polyp


Topic Completed: 1 August 2012

Revised: 13 March 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Peutz-Jeghers polyp[TIAB] small bowel
Page views in 2018: 7,148
Page views in 2019 to date: 3,805
Cite this page: Gulwani H. Peutz-Jeghers polyp. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/smallbowelpeutzjeghers.html. Accessed May 24th, 2019.
Definition / general
  • Polyp supported by broad bands of muscularis mucosa smooth muscle, thicker centrally, resembling Christmas tree at low power
  • Also called hamartomatous polyp
Peutz-Jeghers syndrome
  • Autosomal dominant disorder (1 per 200,000) with variable penetrance, usually diagnosed at age 20 - 30
  • Hamartomatous polyps in small bowel (100%), stomach and colon (25%) - polyps may occur without other features of syndrome, may be associated with enteritis cystica profunda, may cause intussusception and bleeding
  • Polyps are benign but adenocarcinoma may arise from associated adenomatous lesions
  • Melanotic pigmentation of digits, genitalia, lips, oral mucosa, palms, soles
  • Also sex cord tumor with annular tubules (almost all patients); adenocarcinomas of stomach, large or small bowel; adenoma malignum of cervix, ovarian mucinous tumors, carcinomas of breast, lung, pancreas, uterus
Pathophysiology
  • Aberrant intestinal stem cell lineage dynamics in Peutz-Jeghers syndrome leads to protracted clonal evolution in the crypt (Gut 2012;61:839)
Clinical features
Case reports
Clinical images

Case of the Week #272

Endoscopic image



Images hosted on other servers:

Various images

Gross description
  • Adenomatous-like polyps
  • Pedunculated, large, lobulated
Gross images

Images hosted on other servers:

Various images

Microscopic (histologic) description
  • Polyp supported by broad bands of muscularis mucosa smooth muscle, thicker centrally
  • Christmas tree appearance at low power
  • Columnar and goblet cells superficially
  • Paneth and endocrine cells at base
  • Epithelial misplacement (pseudoinvasion) in 10%
Microscopic (histologic) images

Case of the Week #272




Images hosted on other servers:

Various images

Differential diagnosis
Back to top