par Jouret, Anne;Haot, Jules 
Référence Acta endoscopica, 33, 3, page (347-356)
Publication Publié, 2003
Référence Acta endoscopica, 33, 3, page (347-356)
Publication Publié, 2003
Article révisé par les pairs
| Résumé : | Non neoplastic lesions presenting as pseudotumoural masses, nodules or polyps can be found at any level of the digestive tract. They can have different origins: hereditary, congenital inflammatory or mechanical. Peutz-Jeghers lesions represent a good example of hereditary pseudotumours; they are covered by an epithelium indigenous to the site where they develop. Juvenile polyps can be solitary or part of a hereditary disorder. Congenitally misplaced tissues occur by cellular entrapment during embryonic reshaping. They can be pancreatic, gastric or more rarely bronchial. Pancreatic ectopias are quite common in the stomach and small intestine including Meckel's diverticula. Their diagnosis is straightforward when acinar or endocrine tissue is present. Problems occur when they are limited to ducts. In the stomach itself, gastric ectopias give rise to small submucosal nodules. The inflammatory fibroid polyps represent an example of pseudotumoural inflammatory lesions. They are mostly seen in the gastric antrum and in the small intestine where they can induce intussuception. The digestive tract shares with the bladder the astonishing capacity to form during regenerative processes an exuberant endothelial and myofibroblastic tissue mimicking on biopsy a sarcoma or even a carcinoma. Solitary ulcer syndrome due to mechanical causes such as mucosal prolapse, is not restricted to the rectum and can be seen higher in the colon as cap polyps or in the anus as cloacogenic polyps. A correct diagnosis is based on a conjunction of several histological changes. Hyperplastic polyps are frequent in the colon where they must be distinguished from neoplastic polyps. In the stomach they occur mostly in the antrum and can be multiple. They are formed by hyperplastic foveolae and inflammatory chorion. Fundic gland polyps were first described in familial adenomatous polyposis but they can be sporadic. They are small sized, often multiple lesions of uncertain pathogeny. A relation to omeprasole therapy has been suggested by some authors. |
