GI Path Online
Pathology of Fibrovascular
of the Esophagus
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polyps are rare submucosal tumours of the esophagus almost always
originating from the cervical esophagus.
These are benign but potentially life-threatening lesions.
In the past these lesions have been variably classified as "lipomas," "fibromas" and "fibrolipomatous" polyps.
Site: Usually arise in the proximal esophagus behind the cricoid cartilage, frequently from the upper esophageal sphincter.
Age and sex: Most patients are middle-aged or elderly men.
Some cases occur in children or infants and in women.
Clinical presentation: Presents as a large, pedunculated lesion.Patient usually complains of dysphagia, substernal discomfort, and sensation of a mass.
Many fibrovascular polyps have presented as regurgitated masses in the mouth, others have led to airway obstruction as the mass impacted on the larynx.
Gross: Soft, long, polypoid lesion usually covered by normal mucosa.
The lesion is attached by a pedicle to the wall in the cervical esophagus.
The cut surface has a loose, edematous or myxoid look, with white fibrous tissue areas mixed with yellow adipose tissue lobules.
Histologically, the lesion is composed of variable admixtures of mature adipose tissue lobules, collagenous and sometimes myxoid tissue, and prominent vasculature (mixture of muscular arteries, thin-walled veins, and capillaries), all surrounded by mature squamous epithelium.
Numerous plasma cells and mast cells are often present.
Mixture of normal or near-normal stromal tissues suggests that the fibrovascular polyp is not a neoplasm.
It may be an acquired malformation, hamartoma or an unusual form of inflammatory polyp or a lesion related to injury.
Fibrovascular polyps of the esophagus: clinical, radiographic, and pathologic findings in 16 patients. AJR Am J Roentgenol 1996;166:781–787.
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