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Year : 2011  |  Volume : 54  |  Issue : 3  |  Page : 620-621
An atypical, strange area in an adenomatous polyp of the colon: An animal inclusion?


Gastroenterology and Hepatology Clinic-Fundeni Clinical Institute, Bucharest, Romania

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Date of Web Publication20-Sep-2011
 

How to cite this article:
Becheanu G, Dumbrava M, Diculescu M. An atypical, strange area in an adenomatous polyp of the colon: An animal inclusion?. Indian J Pathol Microbiol 2011;54:620-1

How to cite this URL:
Becheanu G, Dumbrava M, Diculescu M. An atypical, strange area in an adenomatous polyp of the colon: An animal inclusion?. Indian J Pathol Microbiol [serial online] 2011 [cited 2020 Nov 30];54:620-1. Available from: https://www.ijpmonline.org/text.asp?2011/54/3/620/85119


Foreign body inclusions in colonic polyps are rarely reported in the literature and we present a case of tomato seed inclusion in an adenomatous polyp.

A 52-year-old woman with a history of rectal bleeding was admitted to our hospital. Colonoscopy revealed two polypoid lesions: A pedunculated one, with a diameter of 1.2 cm and a sessile one with a 1 cm diameter, located at 35 cm from the anal verge. Both lesions were histologically diagnosed as tubular adenomas with moderate epithelial dysplasia (LGD-low grade dysplasia).

In the pedunculated adenoma, the macroscopic examination of the specimen revealed a whitish round-oval area of 2-3 mm in diameter, superficially on the sagittal section.

Microscopically, we noticed an oval structure limited by a clear-cut membrane, with a fuzzy aspect, which included some spiral tubes filled with numerous eosinophilic, erythrocyte-like inclusions [Figure 1] and [Figure 2].
Figure 1: General view of colonic adenomatous polyp with inclusion of unknown origin (Hematoxylin and Eosin (H & E) stain, x40)

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Figure 2: Detail of the polyp, focused on inclusion (H & E stain, x200)

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The image resembles a parasite but the parasitological examination did not certify a specific pathogen. Trying to identify vegetal aspects, we included some seeds in paraffin and we noticed an identical microscopical aspect when analyzing tomato seeds (Lycopersicon esculentum) [Figure 3].
Figure 3: Section on a tomato seed (H and E stain, x200)

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   Discussion Top


The case we present shows a foreign body with pseudo-parasitic or pseudoparasitic features turning out to be a vegetal body included in the superficial area of an adenomatous colonic polyp. In literature only a few cases with foreign body inclusions in colonic polyps were described, namely silk suture and parasitic larvae. [1],[2] Other reports in literature, that link colonic polyps to seeds, are cases of radiological findings in which corn kernels and linseeds mimic multiple polyposis. [3],[4] Velanovich [5] described a case of vegetable seed surrounded by inflammatory tissue, mimicking a 4 mm colonic polyp in a 54-year-old female patient with hematochezia but histological pictures of the lesion were not presented.

 
   References Top

1.Araki Y, Akahoshi K, Harada N, Chijiwa Y, Sasaki I, Nawata H. Two cases of colonic adenomatous polyps accompanied by a migrated surgical suture. Endoscopy 2001;33:85-7.  Back to cited text no. 1
    
2.Bitar M, Strauchen JA, Sequeira RJ, WU M. A case of lower gastrointestinal bleeding and small bowel tumorous masses Arch Path Lab Med 2005;129:800-2.  Back to cited text no. 2
    
3.Harry Press C Jr, Wilkins Davis T, Ingested Foreign Bodies Simulating Polyposis: Report of Six Cases Am J Roentgenol 1976;27:1040-2.  Back to cited text no. 3
    
4.Petty DR, Mannion RA. A case of multiple linseeds mimicking polyposis coli on double contrast barium enema. Clin Radiol 2003;58:87-8.  Back to cited text no. 4
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5.Velanovich V. Vegetable seed simulating colon polyp. Surg Endosc 1995;9:456.  Back to cited text no. 5
[PUBMED]    

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Correspondence Address:
Gabriel Becheanu
C.P. 15-349, 053120, Bucharest
Romania
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.85119

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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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