Inflammatory polyps are
the most common type of polyp in Inflammatory bowel disease. These
polyps usually occur in patients with moderate to severe colitis but
persist in patients with quiescent disease.
Inflammatory polyps also occur in association with Crohn's disease and
other inflammatory disorders of the GI tract such as ischemic colitis or
infectious colitis. These polyps may occur in infective conditions such
as amoebiasis, schistosomiasis and bacillary dysentery.
A special form of inflammatory polyp develops in the colon at the site
of ureteric implantation where probably due to chemical irritation there
is localized expansion of lamina propria and cystic dilatation of
In order to determine the underlying disease it is necessary to examine
non-polypoid mucosa, which should be biopsied at the same time.
developed as a regenerative response to localized or diffuse
inflammation and ulceration of the mucosa followed by regeneration of
the intervening non-ulcerated epithelium. Eventually the regenerated
mucosa become completely re-epithelized and persists above the level of
the surrounding mucosa as inflammatory polyps.
Sometimes inflammatory polyps represent spared mucosa surrounding areas
of deep ulceration.
Some polyps decrease in size , most remain stable a few may continue to
grow if they undergo torsion or prolapse.
sessile, pedunculated or may consist of long finger-like projection
referred to as 'filliform'. These polyps may be single or numerous in
number and the size range between 0.5 - 1.0 cm.
'Giant Inflammatory polyps' may cause bleeding, obstruction, prolapse or
- The inflammatory polyps are characterized
Inflamed lamina propria ; distorted colonic epithelium - tortuous,
branched, elongated and cystic crypts; surface erosion ; congestion ;
haemorrhage ; crypt abscesses.
In some cases pseudosarcomatous changes are noted characterized by
Enlarged spindle or epithelioid shaped multinucleated bizarre stromal
cells.; present at the surface of ulcerated polyp.
[ D/D - Sarcoma ;
1) These lesions lack atypical mitosis 2) Located within granulation
tissue and below areas of ulcerataion 3) Positive for endothelial &
- Rarely dysplasia
or carcinoma may develop in inflammatory polyps. However, the risk of
developing dysplasia is very low and these polyps are not considered