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Clinical pathological cases in gastroenterology: Small intestine and colon

Andres Gelrud, MD, MMSc
Douglas J Hartman, MD
Section Editor
J Thomas Lamont, MD
Deputy Editor
Shilpa Grover, MD, MPH, AGAF


The following cases are meant to illustrate clinical, pathological, and endoscopic findings in patients with a variety of small intestinal and colonic conditions. Detailed discussions on the specific disorders are presented in corresponding topic reviews.


A 51-year-old woman with no significant past medical history underwent a screening colonoscopy. A sessile 6 mm nonbleeding submucosal nodule with smooth contour was visualized in the rectum (picture 1). Biopsy was successfully performed using cold forceps (picture 2A-B). The colonoscopy was otherwise normal to the cecum. (See "Local treatment for gastrointestinal stromal tumors, leiomyomas, and leiomyosarcomas of the gastrointestinal tract", section on 'Colon and rectum'.)


A 44-year-old woman with a family history of colon cancer underwent screening colonoscopy. A single submucosal 5 mm nodule of benign appearance was found in the proximal sigmoid colon (picture 3). Cold forceps biopsies were obtained (picture 4A-C). The colonoscopy was otherwise normal to the cecum. (See "Peripheral nerve tumors" and "Peripheral nerve tumors", section on 'Neurofibroma' and "Neurofibromatosis type 1 (NF1): Pathogenesis, clinical features, and diagnosis", section on 'Peripheral neurofibromas'.)


A 50-year-old man underwent a screening colonoscopy and was noted to have a 10 mm submucosal nodule of benign appearance in the rectum (picture 5). The nodule was resected using hot snare technique and was retrieved (picture 6A-B). The colonoscopy was otherwise normal to the cecum. (See "Clinical characteristics of carcinoid tumors" and "Diagnosis of the carcinoid syndrome and tumor localization" and "Staging, treatment, and posttreatment surveillance of nonmetastatic, well-differentiated gastrointestinal tract neuroendocrine (carcinoid) tumors".)


A 37-year-old woman underwent an upper endoscopy and colonoscopy for the evaluation of iron deficiency anemia and guaiac positive stool. The patient denied any medication use and had no significant past medical or family history. An upper endoscopy was normal. The colonoscopy showed multiple pedunculated polyps throughout the colon ranging in size from 5 to 15 mm that were resected (picture 7 and picture 8). (See "Juvenile polyposis syndrome".)

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Literature review current through: Oct 2017. | This topic last updated: Jul 05, 2017.
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