Small intestine & ampulla
Benign tumors / tumor-like conditions
Hyperplastic polyp
Author: Raul S. Gonzalez, M.D.
Editor-in-Chief: Debra L. Zynger, M.D.
Last author update: 12 January 2021
Last staff update: 19 April 2021
Copyright: 2003-2025, PathologyOutlines.com, Inc.
PubMed Search: Hyperplastic polyp small bowel "loattrfree full text"[sb]
Table of Contents
Definition / general | Essential features | ICD coding | Epidemiology | Sites | Pathophysiology | Clinical features | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Molecular / cytogenetics description | Sample pathology report | Differential diagnosis | Board review style question #1 | Board review style answer #1 | Board review style question #2 | Board review style answer #2Cite this page: Gonzalez RS. Hyperplastic polyp. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ampullahyperplasticpolyp.html. Accessed January 7th, 2025.
Definition / general
- Nonmalignant hyperplastic proliferation of small intestine
Essential features
- Extremely rare benign duodenal / ampullary polyp
- Resembles microvesicular hyperplastic polyp microscopically
ICD coding
- ICD-10: D13.2 - benign neoplasm of duodenum
Epidemiology
- Hyperplastic polyps are extremely rare anywhere in the duodenum
Sites
- Occurs in second part of duodenum and ampulla
Pathophysiology
- Uncertain malignant potential
Clinical features
- Mean age 52 years
- Usually incidentally detected
Case reports
- 58 year old man with ridges in distal duodenum (J Clin Pathol 2006;59:1305)
Microscopic (histologic) description
- Similar to microvesicular hyperplastic polyp of the colorectum, with elongated crypts, superficial serration and decreased goblet cells (Hum Pathol 2011;42:1953)
- No evidence of basal crypt booting (as in sessile serrated adenoma of the colorectum) or gastric foveolar metaplasia
Microscopic (histologic) images
Images hosted on other servers:
Duodenal hyperplastic polyp
Molecular / cytogenetics description
- May harbor KRAS or BRAF mutations
Sample pathology report
- Duodenum, polypectomy:
- Duodenal mucosa with bland hyperplastic and serrated architecture, most consistent with hyperplastic polyp (see comment)
- Comment: Hyperplastic polyps are rare in this location. It is unclear whether they possess premalignant potential.
Differential diagnosis
- Adenoma:
- Far more common, especially in ampulla
- Dysplastic nuclei
- Peutz-Jeghers polyp:
- Contains arborizing musculature
Board review style question #1
Hyperplastic polyps of the small intestine most resemble which type of colorectal polyp microscopically?
- Goblet cell rich hyperplastic polyp
- Microvesicular hyperplastic polyp
- Mucin poor hyperplastic polyp
- Sessile serrated adenoma
Board review style answer #1
Board review style question #2
This polyp was resected from the duodenum. Which of the following is true?
- Deeper levels would show conventional cytologic dysplasia
- These polyps are extremely rare in the small intestine
- This must be a traditional serrated adenoma, despite the lack of abundant eosinophilic cytoplasm
- This patient must have serrated polyposis syndrome
Board review style answer #2
B. These polyps are extremely rare in the small intestine. This is a hyperplastic polyp;
duodenal examples resemble colonic microvesicular hyperplastic polyps.
Comment here
Reference: Hyperplastic polyp
Comment here
Reference: Hyperplastic polyp
