Case Report

Virchows Archiv

, Volume 444, Issue 6, pp 590-593

First online:

Pyogenic granuloma: an unrecognized cause of gastrointestinal bleeding

  • Susanne van EedenAffiliated withDepartment of Pathology, Academic Medical Center Email author 
  • , G. Johan A. OfferhausAffiliated withDepartment of Pathology, Academic Medical Center
  • , Folkert H. MorsinkAffiliated withDepartment of Pathology, Academic Medical Center
  • , Bastiaan P. van ReesAffiliated withDepartment of Pathology, Academic Medical Center
  • , Olivier R. C. BuschAffiliated withDepartment of Surgery, Academic Medical Center
  • , Carel J. M. van NoeselAffiliated withDepartment of Pathology, Academic Medical Center

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Pyogenic granuloma is a lobular capillary hemangioma that mostly occurs on the skin, but it is also encountered on the mucosal surface of the oral cavity. Only a few cases in other parts of the digestive tract have been reported in Japanese patients. In this report, two Caucasian patients are described, who presented with gastrointestinal bleeding due to the presence of a pyogenic granuloma. One was located in the distal esophagus and could be treated with local excision and laser-photocoagulation therapy. The other one was located in the small intestine and was removed by surgical resection. Although extremely rare, pyogenic granuloma as a cause of gastrointestinal bleeding needs consideration. The lesion is benign, presumably reactive and can be adequately treated by excision or laser photocoagulation. Immunohistochemistry and/or polymerase chain reaction for herpesvirus 8 can reliably distinguish pyogenic granuloma from Kaposi’s sarcoma, an important differential diagnosis.


Pyogenic granuloma Esophagus Small intestine Gastrointestinal bleeding HHV-8