Expression of CD34, bcl-2, and kit in inflammatory fibroid polyps of the gastrointestinal tract

The histogenesis of inflammatory fibroid polyps (IFP) of the gastrointestinal tract, focused on the cell of origin of the stromal cells, is a controversial subject. The reported CD34 reactivity in gastric IFP has implied a histogenetic relationship with a variety of CD34-reactive tumors, including gastrointestinal stromal tumors (GIST). In addition to bcl-2, the majority of GIST has expressed Kit, suggesting an origin in interstitial cells of Cajal (ICC), which are selectively localized around nerve plexuses. Gastric (12) and colonic (two) IFP from 13 patients were studied, using antibodies against CD34, bcl-2, and Kit. IFP expanded muscularis mucosae with prominent vascular channels, inflammatory infiltrates, proliferating stromal cells, and extracellular matrix material. Eleven gastric IFP exhibited concentric stromal proliferations (CP), particularly, around vessels, glands, and muscle bundles. Their stromal cells were CD34 reactive, bcl-2 nonreactive, and Kit nonreactive and showed fibroblast-like appearances with thin, long cytoplasmic processes. In contrast, one gastric and two colonic IFP showed no CP, and their stromal cells were CD34 nonreactive, bcl-2 nonreactive, and Kit nonreactive. IFP with CP may have a different histogenesis from IFP without CP. IFP with CP may originate from a subpopulation of dendritic interstitial cells other than ICC, predominantly localized around blood vessels and muscle fibers in muscularis mucosae of the stomach.