Endoscopy 2004; 36(12): 1131
DOI: 10.1055/s-2004-826048
Unusual Cases and Technical Notes
© Georg Thieme Verlag KG Stuttgart · New York

Depressed-Type Hyperplastic Lesion in the Colon

S.  Tamura1 , H.  Ueta2 , T.  Miyamoto2 , H.  Mizuta2 , S.  Onishi1
  • 1Department of Endoscopy, Kochi Medical School, Kochi, Japan
  • 2Division of Gastroenterology, Kochi Municipal Hata-Kenmin Hospital, Kochi, Japan
Further Information

S. Tamura, M. D.

Department of Endoscopy
Kochi Medical School

Kohasu, Okoh-cho
Nankoku
Kochi, 783-8505
Japan

Fax: +81-88-8802338

Email: tamuras@hi-ho.ne.jp

Publication History

Publication Date:
09 May 2006 (online)

Table of Contents

A 77-year-old man was referred for evaluation of anal bleeding. He had no history of any cancer and no family history of colorectal cancer. Colonoscopy using a magnifying videoscope (CF240ZI; Olympus, Tokyo, Japan) was performed and an advanced colon cancer at the rectum and a slightly reddish flat lesion at the ascending colon were detected. The depressed lesion in the ascending colon became obvious when sprayed with 0.2 % indigo carmine solution (Figure [1]). The lesion was about 6 mm in diameter, and the clarified margin of depression was well demarcated. The magnified view of the depressed lesion after spraying with 0.2 % indigo carmine showed a type II pit pattern and a normal round pit pattern (type I) along the marginal elevation according to the classification proposed by S. Kudo et al., indicating that this lesion was hyperplastic [1]. The patient underwent an endoscopic mucosal resection [2]. Histological examination revealed the characteristic non-neoplastic proliferation of serrated tubular profiles of a hyperplastic polyp (Figure [2]).

Zoom Image

Figure 1 The depressed region with marginal elevation became clear at chromoendoscopy.

Zoom Image

Figure 2 Histological appearance of the endoscopic mucosal resection (EMR) specimen showing non-neoplastic proliferation of serrated tubular profiles (hematoxylin and eosin (H&E); original magnification × 35).

There are a few reports of hyperplastic polyps with a variation in the growth pattern that have been described as ”inverted hyperplastic” polyps. The lesion in the case presented here was thought to be the initial lesion of an inverted hyperplastic polyp [3].

Endoscopy_UCTN_Code_CCL_1AD_2AC

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References

S. Tamura, M. D.

Department of Endoscopy
Kochi Medical School

Kohasu, Okoh-cho
Nankoku
Kochi, 783-8505
Japan

Fax: +81-88-8802338

Email: tamuras@hi-ho.ne.jp

#

References

S. Tamura, M. D.

Department of Endoscopy
Kochi Medical School

Kohasu, Okoh-cho
Nankoku
Kochi, 783-8505
Japan

Fax: +81-88-8802338

Email: tamuras@hi-ho.ne.jp

Zoom Image

Figure 1 The depressed region with marginal elevation became clear at chromoendoscopy.

Zoom Image

Figure 2 Histological appearance of the endoscopic mucosal resection (EMR) specimen showing non-neoplastic proliferation of serrated tubular profiles (hematoxylin and eosin (H&E); original magnification × 35).