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What is Vanek’s polyp?

A Vanek’s polyp or inflammatory fibroid polyp (IFP) is a rare, benign, polypoid / sessile lesion occurring in the submucosa of the gastro-intestinal tract, first described by Vanek in 1949 as a “gastric submucosal granuloma with eosinophilia”. Synonyms for this include – inflammatory pseudo-tumour and eosinophilic granuloma. It occurs most frequently (70% of cases) in the stomach followed by the small bowel and rarely in the oesophagus, duodenum and large bowel. The age incidence is usually the sixth decade of life with an equal sex distribution. Clinical presentation depends on the anatomical location. IFPs arising within the stomach produce symptoms of pyloric obstruction, anaemia; those within the small bowel present with obstruction or intussusception. Macroscopically, these lesions are usually solitary, measuring between 2 and 5 cm in diameter arising from the submucosa and may project into the bowel lumen. The mucosal surface is usually ulcerated and pale. The final diagnosis is made at histo-pathology following resection. Microscopically, the stroma is loose and edematous containing thin walled blood vessels and a distinctive appearance that is likened to granulation tissue, diffusely infiltrated with inflammatory cells, mainly eosinophils and a few plasma cells. Mitotic activity is low. Most IFPs are positive for CD34, whereas about 10%–20% of cases show focal reactivity for SMA and desmin. C-KIT (CD117), DOG1, and S-100 are consistently negative . It is associated with PDGFRA mutation.