A poisonous toadstool?

A beautiful polyp removed from the ascending colon.
WHAT IS THE LIKELY DIAGNOSIS?

■ Hyperplastic polyp

CORRECT, or rather more precisely an 'inflammatory polyp'

■ Adenomatous polyp

INCORRECT

■ Malignant polyp

INCORRECT!

explanation

This is a typical inflammatory polyp!  The pathologists call these inflammatory/hyperplastic polyps. However, for clarity I wish that they would simply call them 'inflammatory polyps'. After all, pure 'hyperplastic polyps' are actually a different entity in the colon consisting of mutated epithelium.  In contrast, 'inflammatory polyps' like this one consists of granulation tissue! 

As you probably know, the white spots are superficial caps of fibrinopurulent ulcer slough overlying small spots of ulceration. It remains a mystery why such a spectacular lump of granulation tissue developed in this particular patient. There was no history of NSAID use but the patient did have 'neurofibromatosis' and the lesion was found at a surveillance examination.