www.histopathology-india.net/GIPath.htm

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 & 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.

Microscopic features: 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.

Abstracts:

Giant oesophageal fibrovascular polyp (2005:12b).Eur Radiol. 2006 Mar;16(3):764-6. Epub 2006 Jan 27.

Giant fibrovascular polyp of the esophagus.Dis Esophagus. 2005;18(6):410-2.

Giant fibrovascular polyp of the esophagus. A lesion causing upper airway obstruction and syncope.Arch Pathol Lab Med. 2003;127(4):485-7.

Giant esophageal fibrovascular polyp.Rev Gastroenterol Peru. 2003;23(3): 213-6.

Fibrovascular polyp of the esophagus in infant.Yonsei Med J. 2001;42(2): 264-6

Fibrovascular esophageal polyp as a diagnostic challenge. Dis Esophagus. 2000;13(4):324-7.

Fibrovascular polyps of the esophagus: clinical, radiographic, and pathologic findings in 16 patients. AJR Am J Roentgenol 1996;166:781–787.

Giant fibrovascular polyp of the esophagus.Gastroenterology .1984 ;87(4): 953-6.

Soft Tissue Pathology; Myxoid Tumours of Soft Tissue ;  Classification of Soft Tissue Tumour;  Gross examination of soft tissue specimen ;  A practical approach to histopathological reporting of soft tissue tumours ;  Grading of soft tissue tumours ; Lipomatous tumours ;Neural tumours ; Myogenic tumours ;Vascular tumours ; Fibroblastic/ Myofibroblastic tumours ; Myofibroblastic tumours ;  Fibrohistiocytic tumours ; ChondroOsseous tumours ; Soft TissueTumours of Uncertain Differentiation ; Notochordal Tumour -Chordoma ;Extra-adrenal Paraganglioma ; Gastrointestinal Stromal Tumour ;