Nodular lymphoid hyperplasia – Example
This 20-year-old white male patient underwent colonoscopy with removal of two hyperplastic mucosal polyps in the anal canal 12 years previously after having observed blood in the stool. Colonoscopy seven years ago revealed small polypoid changes in the terminal ileum and on Bauhin’s valve, which did not undergo further change. Histology revealed follicular lymphoid hyperplasia.
The videoclip shows several areas of the terminal ileum. Administration of a spasmolytic agent quieted the initially lively peristalsis. There are numerous free standing polypoid structures visible.
Histology revealed small bowel mucosa with finger-shaped villi and parts of Peyer’s plaques with lymph follicles containing germinal centers.
Nodular lymphoid hyperplasia is a benign change that is often seen in the terminal ileum in children and young adults. The etiology is not clearly understood. Diffuse forms which affect the small bowel, colon and stomach, are sometimes seen in associated with immune defects.
Schwartz DC, Cole CE, Sun Y, Jacoby RF. Diffuse nodular lymphoid hyperplasia of the colon: polyposis syndrome or normal variant? Gastrointest Endosc. 2003;58:630-2