Saturday 1 December 2012
Cowden polyps of the colorectum are generally small and nodular, and the expanded lamina propria is more myofibroblastic than edematous.
The crypts may be surrounded by fibroblasts or myofibroblasts in an onion-skin arrangement and may be arranged in lobular clusters.
Stromal ganglion cells have been described on rare occasions, but are in fact seen quite frequently if one searches for them.
Rare reports of juvenile polyposis with ganglioneuromatous features may in fact be examples CS.
Pathologists frequently fail to suspect a diagnosis of Cowden syndrome.
There may be confusion with juvenile polyps, and juvenile polyposis syndrome (JPS) was initially linked with germline mutation of PTEN as a result of such misdiagnoses.
Cowden polyps may also be mislabeled as hyperplastic polyps.
One large series of juvenile polyposis syndrome (JPS) cases found no examples of stromal ganglion cells.