Friends of Endoscopy
  • Home
  • Quiz Cases
  • Endoscopy Long Cases
  • Short Teaching Clips
  • Blackboard teaching
  • Podcasts
  • Core Reading
    • Basic concepts core reading
    • Gastroscopy core reading
    • Colonoscopy core reading
    • QA core reading
  • About
    • Our sponsors
  • Home
  • Quiz Cases
  • Endoscopy Long Cases
  • Short Teaching Clips
  • Blackboard teaching
  • Podcasts
  • Core Reading
    • Basic concepts core reading
    • Gastroscopy core reading
    • Colonoscopy core reading
    • QA core reading
  • About
    • Our sponsors
Search
Picture
​

Friends of Endoscopy is all about pattern recognition.  See it today and recognise it tomorrow!   Learn from a New Case on most weekdays !!! 
Become a Better Endoscopist ! 

Another pillow sign!!!

7/2/2021

Comments

 
Picture
Just found another colonic lesion demonstrating the pillow sign. 
WHAT IS THE DIAGNOSIS?
■ Lipoma
Doesn't it look translucent?
■ Lymphangioectactic cyst
Yes! Pillow sign + semi-translucent = cyst
■ Phlebectasia
A dilated vein? Nope!
■ Blue rubber naevus syndrome
The naevi are dark and firm!
■ Lymphangiosarcoma
Should then have a large solid component
explanation
 Just when I'd say that all lesions exhibiting the 'pillow sign', I realised that the exception are 'lymphangioectatic cysts' (lymphangiomas) !

These are thought to be developmental malformations which can be found anywhere in or on the body. Of course they are entirely harmless. In fact the only harm they cause is by being poked about!  There has been a reported case of peri-colic abscess formation following biopsy [Krishna SG, Endoscopy. 2012;44(Suppl 2 UCTN):E104–5].  Therefore, either biopsy or a 'de-roofing EMR' should probably be avoided.   

The best way to confirm the diagnosis, if it's in doubt is by EUS.  
It will show several cystic spaces confined to the submucosa and without any nearby nodes. 

​There have been reports of lesions presenting with abdominal pain, and when pedunculated endoscopic resection may be possible [Case Rep Gastroenterol. 2017 Jan-Apr; 11(1): 178–183].   Must admit that I remain a little sceptical. Each case would have to be assessed on its own merit I guess !
Comments

    Categories

    All
    Barrett's
    Cancer
    Cancer Syndromes
    Colitis
    Colorectum
    Corrosive Ingestion
    Crypt Pattern
    Difficulty: Hard
    Difficulty: Moderate
    Difficulty: Very Hard
    Duodenum
    Eosinophilic Oesophagitis
    EUS
    Foveolar Metaplasia
    Gastric
    Gastroscopy
    GI Bleeding
    Histology
    HPB
    Ileum
    Immunosuppression
    Infection
    Local Recurrence Of Barrett's Ca.
    Lymphoma
    Mixed Polyp
    Mucosal Prolapse Syndrome
    NET
    Non-lifting Sign
    Oesophagus
    Opinion Piece!
    Pharynx
    Polyp
    Polypectomy
    The Basics
    TSA

  • Home
  • Quiz Cases
  • Endoscopy Long Cases
  • Short Teaching Clips
  • Blackboard teaching
  • Podcasts
  • Core Reading
    • Basic concepts core reading
    • Gastroscopy core reading
    • Colonoscopy core reading
    • QA core reading
  • About
    • Our sponsors