Mesenchymal tumors

Pyogenic granuloma

Topic Completed: 17 February 2021

Minor changes: 3 March 2021

Copyright: 2003-2021,, Inc.

PubMed search: colonic pyogenic granuloma

Raul S. Gonzalez, M.D.
Page views in 2020: 3,313
Page views in 2021 to date: 3,558
Cite this page: Gonzalez RS. Pyogenic granuloma. website. Accessed October 23rd, 2021.
Definition / general
  • Benign capillary hemangioma forming a colonic polyp
Essential features
  • Very rare
  • Can cause rectal bleeding
  • Also called lobular capillary hemangioma
  • Usually occurs in skin or oral cavity; gastrointestinal tract cases are very rare
Clinical features
  • Presents clinically as rectal bleeding and anemia
Case reports
Clinical images

Images hosted on other servers:

Jejunal pyogenic granuloma

Upper duodenum findings

Endoscopic duodenal mucosal resection

Gross description
  • Pedunculated or sessile polyp
  • May appear black and necrotic
Microscopic (histologic) description
  • Lobular arrangement of capillaries within edematous, inflamed stroma
  • Endothelial cells often swollen
  • Often shows surface ulceration; sometimes shows mitotic figures
Microscopic (histologic) images

Images hosted on other servers:

High power H&E

IHC for CD31 and CD34

Duodenum-edematous granulation tissue

Jejunum postsurgical pyogenic granuloma


Positive stains
Sample pathology report
  • Transverse colon, polypectomy:
    • Small focus of benign lobular vascular proliferation, most consistent with pyogenic granuloma
Differential diagnosis
Board review style question #1
A 21 year old man presents to his physician, complaining of hematochezia. Colonoscopy shows a small, pedunculated polyp. Microscopically, the polyp is mostly composed of inflammation and small blood vessels. Which of the following findings would favor a diagnosis of pyogenic granuloma?

  1. Dilated, ectatic crypts
  2. Lobular architecture
  3. Positivity for HHV8
  4. Surface adenomatous change
  5. Viral cytopathic effect
Board review style answer #1
B. Lobular architecture

Comment here

Reference: Pyogenic granuloma
Back to top
Image 01 Image 02