Endoscopic picture of pseudopolyposis in inflammatory bowel diseases

Abstract

Aim. To evaluate the frequency of pseudopolypes (PP), as well as their histological structure in patients with inflammatory bowel diseases (IBD). Materials and methods. 165 patients with IBD were examined (113 with ulcerative colitis (UC), 52 with Crohn’s disease (CD)). All patients underwent ileocolonoscopy with taking the material for histological examination in case pseudopolypes were detected. Results. It was revealed that pseudopolypes were found in 27% of patients with IBD (in UC - in 29%, CD - 23%). In different phases of the inflammatory process in UC, the number of PP was comparable to each other. In CD, PP was statistically significantly more often detected at the stage of scars and outside of exacerbation than in the phases of infiltration and ulcers. During histological examination of biopsy material from PP tissue hyperplasia, inflammatory polyp and granulation tissue were verified. Adenoma was detected in one case in each of the IBD. Crypt abscesses and crypt discomplexation were found only with exacerbation of UC. Conclusion. Based on the results of our study, pseudopolypes occur in both UC and CD in different phases of the inflammatory process, which indicates the absence of specificity of these tumors for any of the IBD. The identification of a large number of PP at a pronounced stage of UC, in our opinion, indicates the connection of PP with an aggressive attack, which can serve as one of the criteria for predicting the course of UC. The cellular composition of PP in most cases reflected inflammation or healing of erosive and ulcerative defects, as well as in a small number of cases, the presence of adenoma. Thus, PP requires careful examination during endoscopic examination, if there is a suspicion of neoplasia or dysplasia in the PP tissue, biopsies must be taken for histological examination.