Question

A 5-year-old child presented with a history of blood in the stools. On examination, there was a polypoid mass in the rectum, a biopsy of which is shown below. The most probable diagnosis is:

• A. Villous adenoma
• B. Juvenile polyp
• C. Vascular malformation
• D. Serrated adenoma

Hint:

Age under 5 with rectal bleeding and cystic mucin-filled glands points to a hamartomatous polyp.

Answer 1

The Correct Option is B

Step 1: A solitary pedunculated rectal polyp causing painless bleeding in a young child, with biopsy showing dilated cystic glands filled with mucin and inflammatory debris in an inflamed lamina propria, is a juvenile (retention) polyp.

Step 2: Juvenile polyps are smooth-surfaced, reddish, pedunculated lesions usually less than 3 cm. They are hamartomatous, most common in children under 5 years, and typically present with rectal bleeding. The sporadic solitary form carries no malignant potential.

Step 3: Why the others are wrong. Villous adenoma and serrated adenoma are dysplastic neoplastic polyps of adults, not young children. Vascular malformation would not show dilated mucin-filled cystic glands.

Ref: Robbins Basic Pathology, 9th edition, pg 592.