case_images: PMC11785670_01
case_images: Endoscopic findings of the colonic polyp. a Colonoscopy shows a 20 mm pedunculated polyp in the sigmoid colon. b Indigo carmine spraying image. Magnified endoscopic images of the head (c) and base (d) of the polyp. An open or elongated pit is shown on the surface of the polyp
case_images: 12328_2024_2059_Fig1_HTML.jpg
case_images: PMC11785670_01_12328_2024_2059_Fig1_HTML.jpg
case_images: Fig1
case_images: A 20 mm erythematous raised lesion was observed in the sigmoid colon (Fig. 1). Indigo carmine spray revealed an open or elongated pit on the surface of the polyp (Fig. 1b-d). The intervening part of the pits was enlarged (Fig. 1c).
case_images: Magnified endoscopic images with narrow-band imaging and crystal violet staining. a Overall picture of the polyp. b The red box indicates the base of the polyp with a regular surface pattern. c, e The yellow box indicates the head of the polyp with a tubular or branched surface pattern. Cristal violet staining shows a mixture of type IIIL and type IV pit patterns. d, f The blue box indicates the center of the polyp. The surface pattern is varied, with dense vessels in the intervening part. Cristal violet staining shows an area of indistinct pit structure
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case_images: PMC11785670_01_12328_2024_2059_Fig2_HTML.jpg
case_images: Fig2
case_images: Magnified endoscopy with narrow-band imaging revealed that the base of the polyp had a regular and cribriform-like surface pattern (Fig. 2b), and the head had a tubular or branched surface pattern (Fig. 2c). The center of the polyp had a varied surface pattern with dense vessels in the intervening part (Fig. 2d). Crystal violet staining showed that the polyp head had a mixture of type IIIL and type IV pit patterns (Fig. 2e). The center of the polyp had an area of indistinct pit structure (Fig. 2f). Although it was difficult to accurately contrast the endoscopic image with the pathological specimen, we inferred that the area of high-grade dysplasia was in the center of the polyp (Fig. 2d, f).
case_images: Microscopic findings of the excised polyp. a, b Histopathological loupe images of hematoxylin and eosin (HE) and desmin staining. c, d Low-power view of HE and desmin staining. Histopathological examination shows arborizing proliferation of smooth muscle bundles covered by hyperplastic epithelium. e Low-power view showing a focus of high-grade dysplasia within the epithelium (blue box in Fig. 3a). f High-power view showing high-grade dysplasia (green box in Fig. 3e)
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case_images: PMC11785670_01_12328_2024_2059_Fig3_HTML.jpg
case_images: Fig3
case_images: Histopathological examination revealed an arborizing proliferation of hyperplastic epithelia with smooth muscle bundles, consistent with a PJ-type hamartomatous polyp (Fig. 3a-d). Additionally, a small number of irregular crypts with high-grade dysplasia were observed within the hyperplastic epithelium (Fig. 3e, f).