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

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 20 February 2018, last major update August 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Peutz-Jeghers polyp[TIAB] small bowel

Cite this page: Gulwani, H. Peutz-Jeghers polyp. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/smallbowelpeutzjeghers.html. Accessed July 22nd, 2018.
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

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Endoscopic image



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Various images

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

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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

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Case of the Week #272:




Images hosted on other servers:

Various images

Differential diagnosis