Odd finding at surgical anastomosis
This patient has undergone a right hemicolectomy for cancer some 2 years earlier. He now attends for his first "post - surgery" colonic surveillance examination. This was found at the anastomosis.
WHAT IS YOUR DIAGNOSIS?
■ Granulation tissue
You ARE Right!!!
■ Adenomatous change
■ Suspicious for tumour seeding
Looks odd but not because it's cancer!
There is no discernible crypt pattern, not because of cancer, but because these polyps are composed purely of granulation tissue! I also thought that it looked a little odd and took some samples (which I don't usually do when my endoscopic diagnosis is of "granulation tissue" at an anastomosis). Here is another example of granulation tissue, this time at a colonic EMR site, which looks worrying to the unwary ☺!