Virtual Slidebox
Presented by the MGH Pathology Service

62 year old F with diarrhea.

Clinical summary
42 yo M with cecal tumor.

7 year old with history of previous polyps. F/U colonoscopy shows several new polyps as shown here. Has frequent nosebleeds!

34 year old M with diarrhea.

18 year old F with diarrhea.

78 yo male with chronic watery diarrhea

MICROSCOPIC FEATURES

• Spindle cell proliferation infiltrating the lamina propria, with interspersed ganglion cells, sometimes forming nests
• There may be associated distortion of the crypt architecture
• In ganglioneuromatous polyposis (see below), multiple exophytic polyps are formed
• Diffuse ganglioneuromatosis (see below) is centered in the myenteric plexus and extends into the lamina propria, and can lead to transmural involvement and stricture formation

Read more on Colonic ganglioneuroma…

50 year old with history of multiple skin lesions. Polyp found on routine colonoscopy.

MICROSCOPIC FEATURES

• Marked lymphoid follicular hyperplasia, with prominent germinal centers, and chronic inflammation of the lamina propria
• Variable crypt inflammation and architectural distortion
• Aphthous ulcers may develop

DIFFERENTIAL DIAGNOSIS

Read more on Diversion colitis, with superimposed ulcerative colitis…

2 year old with history of previous polyps. F/U colonoscopy shows 2 new polyps as shown here. Does not have nose bleeds!

75 year old M with diarrhea.

55 yo female with chronic watery diarrhea

79 yo male with chronic watery diarrhea

1 year old with ileal intussusception

MICROSCOPIC FEATURES

• Dilated mucosal capillaries with hyalinized walls
• Endothelial nuclei are not prominent, and there is no hyalinization of the surrounding lamina propria
• Otherwise normal mucosa and submucosa

Read more on Portal hypertensive colopathy…

60 yo M with diarrhea. Total colectomy.

46 y/o male with severe diarrhea

72 yo M with colon polyp. Polypectomy.

Male in his 40’s with a colon polyp. Polypectomy.

10 year old boy with abnormal eye exam. Had colectomy after clinical work-up

12 year old with bloody diarrhea