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Case Reports in Pathology
Volume 2015 (2015), Article ID 646270, 3 pages
http://dx.doi.org/10.1155/2015/646270
Case Report

Inverted Lymphoglandular Polyp in Descending Colon

1Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
2Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
3Department of Pathology, LAC+USC Medical Center, Los Angeles, CA 90033, USA

Received 13 November 2014; Revised 28 January 2015; Accepted 29 January 2015

Academic Editor: Hiroko Kuwabara

Copyright © 2015 Shengmei Zhou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 47-year-old male with a history of left colon cancer, status post left colon resection for 12 years, presented with rectal bleeding. Colonoscopic examination revealed an 8 mm sessile polyp in the proximal descending colon. Microscopic examination showed that the surface of this polyp was covered with a layer of normal colonic mucosa with focal surface erosion. In the submucosal layer, an intimate admixture of multiple cystically dilated glands and prominent lymphoid aggregates with germinal centers was seen. The glands were lined by columnar epithelium. Immunohistochemical staining showed the glands were positive for CK20 and CDX2 and negative for CK7, with a low proliferative index, mostly consistent with reactive colonic glands. The patient remained asymptomatic after one-year follow-up. A review of the literature shows very rare descriptions of similar lesions, but none fits exactly this pattern. We would designate this inverted lymphoglandular polyp and present this case to raise the awareness of recognizing this unusual histological entity.