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WHO Classification of Tumours
Fibroepithelial polyp
Anus and anal canal


Definition

Also called fibrous polyp or anal tag, this is one of the most frequent anal lesions and is found at the dentate line, anal mucosa or in the perianal skin
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Wienert V, Albrecht O, Gahlen W (1978)
[Results of incidence analyses in external hemorrhoids].
Hautarzt 29: 536-40



. Fibroepithelial polyps may be associated with local inflammation such as fissure or fistula
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Lock MR, Thomson JP (1977)
Fissure-in-ano: the initial management and prognosis.
Br J Surg 64: 355-8



. Granulomas can be found in about one third of skin tags in cases of Crohn disease
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Taylor BA, Williams GT, Hughes LE, Rhodes J (1989)
The histology of anal skin tags in Crohn's disease: an aid to confirmation of the diagnosis.
Int J Colorectal Dis 4: 197-9



. Others may represent the end stage of a thrombosed haemorrhoid, but remnants of haemorrhoidal vessels or signs of previous bleeding are rarely found. Most are probably of idiopathic nature as the incidence is rather similar in patients with or without anal diseases
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Wienert V, Albrecht O, Gahlen W (1978)
[Results of incidence analyses in external hemorrhoids].
Hautarzt 29: 536-40



.
Grossly, the polyp is spherical or elongated with a greater diameter ranging from a few millimetres up to 4 cm. The surface is white or grey and may show superficial ulceration. Histologically, it consists of a fibrous stroma covered by squamous epithelium, which usually is a slightly hyperplastic and may be keratinized. The stroma may be more or less dense and often contains fibroblastic cells with two or more nuclei and a considerable number of mast cells

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Groisman GM, Polak-Charcon S (1998)
Fibroepithelial polyps of the anus: a histologic, immunohistochemical, and ultrastructural study, including comparison with the normal anal subepithelial layer.
Am J Surg Pathol 22: 70-6



. Neuronal hyperplasia is a common feature
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Fenger C, Schrøder HD (1990)
Neuronal hyperplasia in the anal canal.
Histopathology 16: 481-5




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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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Topographic definition of the anal canal, anal margin and perianal region