Small intestine & ampulla
Benign tumors / tumor-like conditions
Hyperplastic polyp

Editor-in-Chief: Debra L. Zynger, M.D.
Raul S. Gonzalez, M.D.

Topic Completed: 12 January 2021

Minor changes: 19 April 2021

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PubMed Search: Hyperplastic polyp small bowel "loattrfree full text"[sb]


Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez RS. Hyperplastic polyp. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ampullahyperplasticpolyp.html. Accessed May 6th, 2021.
Definition / general
  • Nonmalignant hyperplastic proliferation of small intestine
Essential features
  • Extremely rare benign duodenal / ampullary polyp
  • Resembles microvesicular hyperplastic polyp microscopically
ICD coding
  • ICD-10: D13.2 - benign neoplasm of duodenum
Epidemiology
  • Hyperplastic polyps are extremely rare anywhere in the duodenum
Sites
  • Occurs in second part of duodenum and ampulla
Pathophysiology
  • Uncertain malignant potential
Clinical features
  • Mean age 52 years
  • Usually incidentally detected
Case reports
Microscopic (histologic) description
  • Similar to microvesicular hyperplastic polyp of the colorectum, with elongated crypts, superficial serration and decreased goblet cells (Hum Pathol 2011;42:1953)
  • No evidence of basal crypt booting (as in sessile serrated adenoma of the colorectum) or gastric foveolar metaplasia
Microscopic (histologic) images

Images hosted on other servers:

Duodenal hyperplastic polyp

Positive stains
  • Epithelial cells express MUC2 (focal), MUC5AC and MUC6 (crypt bases)
Molecular / cytogenetics description
  • May harbor KRAS or BRAF mutations
Sample pathology report
  • Duodenum, polypectomy:
    • Duodenal mucosa with bland hyperplastic and serrated architecture, most consistent with hyperplastic polyp (see comment)
    • Comment: Hyperplastic polyps are rare in this location. It is unclear whether they possess premalignant potential.
Differential diagnosis
Board review style question #1
Hyperplastic polyps of the small intestine most resemble which type of colorectal polyp microscopically?

  1. Goblet cell rich hyperplastic polyp
  2. Microvesicular hyperplastic polyp
  3. Mucin poor hyperplastic polyp
  4. Sessile serrated adenoma
Board review style answer #1
B. Microvesicular hyperplastic polyp

Comment here

Reference: Hyperplastic polyp
Board review style question #2

This polyp was resected from the duodenum. Which of the following is true?

  1. Deeper levels would show conventional cytologic dysplasia
  2. These polyps are extremely rare in the small intestine
  3. This must be a traditional serrated adenoma, despite the lack of abundant eosinophilic cytoplasm
  4. This patient must have serrated polyposis syndrome
Board review style answer #2
B. These polyps are extremely rare in the small intestine. This is a hyperplastic polyp; duodenal examples resemble colonic microvesicular hyperplastic polyps.

Comment here

Reference: Hyperplastic polyp
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