Nearby 'chicken skin' mucosa...
This is the colonic mucosa close to a sigmoid polyp.
WHAT IS THE SIGNIFICANCE?
■ It's of NO significance!
■ It indicates a nearby cancer
I don't apply any significance to this finding! Below is an image from the low rectum of a patient with SPECTACULAR 'chicken skin appearance' of the low rectal mucosa. However, there was no nearby lesion and histology reported: "These biopsies are all normal. There are no features to suggest a diagnosis of active idiopathic inflammatory bowel disease or microscopic colitis and there is no evidence of dysplasia or neoplasia"
It was first suggested that this finding indicate that the polyp is malignant and that the chicken skin appearance is caused by lymphatic infiltration by cancer. However, with time it became clear that this was rarely the case. More recently it was suggested that the finding was more common in polyps harbouring HGD (Intest Res. 2015;13(4):318–25).
However, I am convinced that it's actually mucosal 'trauma' which causes this 'chicken skin' appearance. In the case below, it was perhaps from straining on the toilet. When you see this close to a nearby polyp, the trauma is probably from the colonic peristalsis which intermittently pulls on the polyp. Of course, larger polyps are likely to be yanked more violently by the peristalsis and the link is therefore between the size and the location of the polyp rather than the histology.
It was therefore entirely predictable that the authors found a link between 'chicken skin mucosa' and pedunculated or sessile polyps rather than flat polyps and 2) that the sign was most common in the sigmoid and rectum (because these generate the most propulsive force)!