Table of Contents
Definition / general | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Gulwani H. Inflammatory fibroid polyp. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/smallbowelinflammatoryfibroidpolyp.html. Accessed March 29th, 2025.
Definition / general
- Uncommon, benign polypoid submucosal mass with CD34+ spindle cells and granulation tissue, usually in distal stomach or terminal ileum (Arch Pathol Lab Med 2011;135:1311)
- Presents as obstructive mass or causing intussusception (Radiographics 1999;19:539)
- True neoplasms, usually with PDGFRA mutation (Pathologe 2009;30:117)
Case reports
- 35 year old woman with concurrent appearance of Crohn's disease and inflammatory fibroid polyp (Ann Ital Chir 2005;76:395)
Treatment
- Excision (does not recur)
Gross description
- Polypoid (without stalk), submucosal mass, dumbbell shape in small intestine due to intussuception, mucosal ulceration and splitting and atrophy of muscularis propria
Microscopic (histologic) description
- Submucosal mixture of prominent capillaries, spindle cells (occasionally concentrically arranged around vessels / onion skinning) and inflammatory cells (particularly eosinophils, plasma cells and mast cells) in granulation tissue-like stroma (Arch Pathol Lab Med 2010;134:378)
- May be transmural
- May have lymphoid follicles
- Rare multinucleated giant cells, no atypia, no / rare mitotic figures
- Histologic patterns: classical, edematous, fibrovascular, nodular, sclerotic
Positive stains
Negative stains
- CD117 (although mast cells are positive)
Differential diagnosis
- GIST: malignant in 30 - 50%, plump spindle cells with eosinophilic cytoplasm, variable skenoid fibers and muscular infiltration, CD117+ (Mod Pathol 2000;13:1134, Mod Pathol 2003;16:366)
- Inflammatory myofibroblastic tumor: usually children, may recur, plasma cells and lymphocytes with few eosinophils, mitotic activity in cellular areas, less prominent blood vessels, smooth muscle actin+, desmin+, ALK±, CD34- (Hum Pathol 2002;33:307)
- Inflammatory polyp of Crohn's or ulcerative colitis: similar histology but different clinical history and findings in remainder of bowel