Case Report
Copyright ©The Author(s) 2015.
World J Gastrointest Endosc. Nov 25, 2015; 7(17): 1257-1261
Published online Nov 25, 2015. doi: 10.4253/wjge.v7.i17.1257
Table 1 Reported small intestinal polyps secondary to portal hypertension (including current case)
Ref.Age (yr)/genderLocation(s)Number/sizes of polypsPathologic findingsEtiology of portal hypertension
Current report52/MDuodenal bulb to second portionGreater than 7, majority 1-2 mm, largest 8 mmVilliform hyperplasia of reactive intestinal and gastric foveolar epithelium, proliferating ectatic and congested lamina propria vesselsAlcoholic cirrhosis
Pillai et al[2]55/M1st portion of duodenum“multiple sessile polyps”, sizes NSPolypoid muocsa lined by small intestinal and gastric foveolar type epithelium with ectatic capillaries, fibrosis and smooth muscle proliferation of lamina propriaAlcoholic cirrhosis
Zeitoun et al[3]70/M2nd portion of duodenumSingle polyp, 3 cmNumerous thick-walled capillaries with vascular ectasia in lamina propriaAlcoholic cirrhosis
1Lemmers et al[4]50/FJueuno-ileal“Several”, > 5 mmLamina propria vascular dilation and thrombi without epithelial atypiaHepatitis C cirrhosis
73/MJejunalTwo “bumps”, < 5 mmNot biopsiedCryptogenic cirrhosis
67/MDuodenal“Several”, 5 mmLamina propria vascular dilation and inflammation with epithelial atypia and ulcerationAlcoholic cirrhosis
74/FAntral/duodenal“Several”, 15 mmLamina propria vascular dilation and epithelium with crenellated glandsHepatitis C cirrhosis
66/FDuodenal/jejuno-ileal“Several”, 5/< 5 mmNot biopsiedCryptogenic cirrhosis
Devadason et al[5]6 yr/M1st and 2nd portion of duodenum“polyps”, sizes NSLobular capillary proliferation in a hemagiomatous pattern in lamina propriaEHPVO
4 yr/F2nd portion of duodenum“numerous”, sizes NSLobular capillary proliferation in a hemagiomatous pattern in lamina propriaEHPVO
1 yr/F2nd portion of duodenum“polyps”, sizes NSPolyp not biopsied, mucosa adjacent to polyp with ecatsia and congestion of lamina propria with smooth muscle hypertrophyEHPVO
Table 2 Histological differential diagnosis of polyps in the duodenum
Duodenal adenoma/adenocarcinoma
Ampullary adenoma/adenocarcinoma
Hyperplasia, heterotopias, ectopias, inflammatory
Brunners gland hyperplasia/hamartoma
Gastric/pancreatic hetertopia/ectopia
IBD associated inflammatory pseudopolyps
Inflammatory fibroid polyp
Peutz Jegher polyps
Juvenile polyps (JPS or PTEN associated)
Cronkhite-Canada syndrome polyps
Neuroendocrine tumors
Mixed adenocarcinoma neuroendocrine carcinoma
Gangliocytic paranglioma
Gastrointestinal stromal tumor
Granular cell tumor
Kaposi sarcoma
Lymphoid hyperplasia
B and T cell lymphomas
MiscellaneousMalakoplakia, mucosal prolapse related, lymphangiectasia, xanthoma