Syndromic and sporadic inflammatory/hyperplastic small-bowel polyps: a comparative study

Background: Inflammatory/hyperplastic small-bowel polyps (SBPs) occur either sporadically or in patients with a polyposis syndrome; however, comparison between these two settings of the histological features of SBPs has not been reported and the etiology of sporadic inflammatory/hyperplastic SBPs remains unclear. Method: Twenty-eight cases of sporadic inflammatory/hyperplastic SBPs and nine cases of syndromic SBPs were retrieved from the Department of Anatomic Pathology at the Cleveland Clinic. Clinico-demographics and histological features were compared between the two groups. Results: Patients with syndromic inflammatory/hyperplastic SBPs were younger (48 vs. 63 years; P0.007) and had higher rates of hemorrhagic telangiectasia (55.6 % vs. 0%; P0.000), gastric polyps (87.5 % vs. 21.4%; P0.001), and family history of colon cancer (62.5 % vs. 11.1%; P0.014). Sporadic cases were more frequently associated with gastro-esophageal reflux (35.7 % vs. 0%; P0.079) and anti-reflux medication use (55.6 % vs. 11.1%; P0.026). Histologically, the syndromic SBPs were more often of pure intestinal type (45.4 % vs. 3.8%; P0.005) and had prominent vessels (81.8 % vs. 42.3%; P0.036). Conclusions: Patients with syndromic SBPs are younger and have higher rates of hemorrhagic telangiectasia, gastric polyps, and family history of colon cancer. Histologically, syndromic inflammatory/hyperplastic SBPs are more likely to be of pure intestinal type and to have prominent vessels. Key words: hyperplastic polyp; inflammatory polyp; small bowel; juvenile polyp; polyposi