Other nonneoplastic

Colitis cystica profunda

Topic Completed: 14 April 2021

Minor changes: 21 April 2021

Copyright: 2003-2021,, Inc.

PubMed Search: colitis cystica profunda

Raul S. Gonzalez, M.D.
Page views in 2020: 3,413
Page views in 2021 to date: 2,686
Cite this page: Gonzalez RS. Colitis cystica profunda. website. Accessed September 21st, 2021.
Definition / general
  • Reactive mucosal change characterized by submucosal mucin filled cysts lined by benign epithelium
Essential features
  • Mucosal herniation into submucosa secondary to various forms of injury
  • Bland histology distinguishes from a true invasive process
  • Also called colitis cystica polyposa or hamartomatous inverted polyp when presents as polypoid lesion
  • Uncommon; male predilection
  • Can occur anywhere in GI tract, including stomach (gastritis cystica profunda) and small intestine (enteritis cystica profunda)
  • Secondary to mucosal damage due to ulcerative colitis, Crohn's 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
Radiology images

Images hosted on other servers:

Barium imaging shows filling defect

Case reports
  • Patient education to avoid straining, high fiber diet with bulk laxatives, surgery for rectal prolapse
Clinical images

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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
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.
Colitis cystica profunda

Colitis cystica profunda

Sample pathology report
  • Rectum, mass, biopsy:
    • Colitis cystica profunda
    • Negative for dysplasia or malignancy.
Differential diagnosis
Board review style question #1

A patient undergoes routine colonoscopy and is found to have a submucosal mass. A mucosal biopsy is unremarkable and surgery is performed. What is the best diagnosis?

  1. Colitis cystica profunda
  2. Mucinous adenocarcinoma
  3. Pneumatosis cystoides intestinalis
  4. Tubular adenoma with pseudoinvasion
Board review style answer #1
A. Colitis cystica profunda

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