Endoscopic features of solitary colorectal hamartomatous polyps: solitary juvenile polyp and Peutz-Jeghers polyp

Abstract

Background and study aims: The aim of this study was to clarify the endoscopic characteristics of colorectal hamartomatous polyps, including solitary juvenile polyp (JP) and solitary Peutz-Jeghers polyp (PJP). Patients and methods: We reviewed the clinicopathological and endoscopic findings of 151 colorectal polyps with a diagnosis of solitary JP or solitary PJP. The clinicopathological and endoscopic findings of 119 JPs and 32 PJPs were retrospectively compared. Results: Endoscopic findings included significantly higher incidences of erosion, whitish exudates, and chicken-skin mucosa in JPs compared to PJPs. A lobular surface was more common in PJPs. Magnified narrow-band imaging endoscopic findings indicated that expanded crypt openings, sparse marginal crypt epithelia, and proliferation of capillary vessels were characteristic of JPs. Branching structures were more prevalent in PJPs. Magnifying chromoendoscopy found a predominance of star-like pit patterns and decreased pit densities in JPs, whereas tubular and branching pit patterns were more frequent in PJPs. Neither type of polyp was found to contain adenomas, dysplasia, or malignant cells. Combinations of specific characteristic endoscopic findings in the JPs and PJPs showed high diagnostic accuracy for those polyps. Conclusions: Solitary JPs and PJPs in the colorectum manifested characteristic endoscopic findings, and combinations of specific characteristic endoscopic findings may be useful for the endoscopic diagnosis of solitary JPs and PJPs.