Colonic Filiform Polyposis in a Patient without Inflammatory Bowel Disease

Filiform polyposis is an uncommon entity that is most often encountered in the colon of patients with a history of inflammatory bowel disease (IBD). We report a case of filiform polyposis occurring in a 71-year-old man with no history, or symptoms of IBD. The patient was found to have numerous polypoid lesions in the ascending and proximal transverse colon endoscopically and underwent hemicolectomy. Gross examination revealed numerous finger-like polyps spreading in the ascending colon and transverse colon. Histologic evaluation of the excised specimen demonstrated the polyps lined by cytologically bland colonic mucosa with fibrovascular cores. Acute and chronic inflammation including crypt abscesses was focally present. No significant ulcerations, granulomas, dysplasia or malignancy were identified. The diagnosis was filiform polyposis and he had an uneventful postoperative course. The pathogenesis of colonic filiform polyposis is still uncertain. Filiform polyps themselves are not considered precancerous in the patients without IBD.