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Pathology of Fibrovascular

Polyps (Giant

Fibrovascular Polyps)

of the Esophagus

Dr Sampurna Roy MD

 

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Esophageal Pathology- Home Page

    

                                                                                                                      

 

 

Fibrovascular 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.

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.

Further reading:

Giant oesophageal fibrovascular polyp 

Giant fibrovascular polyp of the esophagus.

Giant fibrovascular polyp of the esophagus. A lesion causing upper airway obstruction and syncope.

Giant esophageal fibrovascular polyp.

Fibrovascular polyp of the esophagus in infant.

Fibrovascular esophageal polyp as a diagnostic challenge.

Fibrovascular polyps of the esophagus: clinical, radiographic, and pathologic findings in 16 patients. AJR Am J Roentgenol 1996;166:781787.

Giant fibrovascular polyp of the esophagus.

 

 

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Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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