Colon
Other nonneoplastic
Colitis cystica profunda
Author: Raul S. Gonzalez, M.D.
Topic Completed: 1 August 2013
Minor changes: 1 October 2020
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed Search: colitis cystica profunda
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Pathophysiology | Clinical features | Radiology description | Radiology images | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Differential diagnosisCite this page: Gonzalez R. Colitis cystica profunda. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/coloncystitiscystica.html. Accessed March 4th, 2021.
Definition / general
- Reactive mucosal change characterized by submucosal mucin filled cysts lined by benign epithelium
Terminology
- Also called colitis cystica polyposa or hamartomatous inverted polyp when presents as polypoid lesion
Epidemiology
- Uncommon; male predilection
Sites
- Can occur anywhere in GI tract, including stomach ("gastritis cystica profunda") and small intestine ("enteritis cystica profunda")
Pathophysiology
- Secondary to mucosal damage due to ulcerative colitis, Crohn disease, radiation, diverticulitis or other inflammation / ulceration of bowel; mucus follows granulation tracts to involve large areas of bowel
Clinical features
- Stools contain blood or mucus; patients may have diarrhea or abdominal pain
Radiology description
- Can mimic a malignant process (Abdom Imaging 2007;32:239)
Radiology images
Images hosted on other servers:
Barium imaging shows filling defect
Case reports
- 41 year old woman with recurrence after 20 years (Chir Ital 2005;57:789)
- 42 year old man with diverticulitis (Am J Gastroenterol 2011;106:172)
- After radiation for bladder carcinoma (Arch Pathol Lab Med 1995;119:1170)
Treatment
- Patient education to avoid straining, high fiber diet with bulk laxatives, surgery for rectal prolapse
Clinical images
Images hosted on other servers:
Submucosal abnormality
Gross description
- May appear as a polypoid or submucosal mass
Microscopic (histologic) description
- Either localized or diffuse; similar histology to colorectal polyps in Cowden syndrome although "inverted"
- Misplaced benign colonic epithelium forming cystic spaces filled with mucin and surrounded by lamina propria; mucin may extravasate into surrounding tissue
Differential diagnosis
- Mucinous (colloid) carcinoma: infiltrating, epithelium floats in mucin, glandular atypia, tumor desmoplasia, no hemorrhage or hemosiderin, no lamina propria
- Solitary rectal ulcer syndrome: may be indistinguishable in late cases of colitis cystica profunda
- Ulcerative colitis: no fibromuscular obliteration of lamina propria
