Saturday, May 31, 2014

Diary of a Crohn's Flare: February colonoscopy details

I got a copy of the physician's report from my late February colonoscopy.

FINAL PATHOLOGIC DIAGNOSIS:
A. Colon, cecum, polyp, polypectomy:
Tubular adenoma, negative for high grade dysplasia or
malignancy.
B. Colon, sigmoid and rectum, biopsy:
Colonic mucosa with congestion and focal neutrophilic
inflammation.
Negative for features of lymphocytic or collagenous colitis.
Negative for granulomas, dysplasia or malignancy.
Comment: The biopsies from the sigmoid colon and rectum show
colonic mucosa with intact architecture, focal congestion
and focal neutrophilic inflammation of the crypts. No basal
lymphoplasmacytosis, architectural disarray, Paneth cell
metaplasia, granulomas, dysplasia or malignancy is
identified. Clinical correlation is recommended.

COMMENTS:

CLINICAL HISTORY:
Signs, symptoms, medications and previous diagnoses:
Crohn's disease of small bowel and colon, follow up of
Crohn's disease of small bowel and colon.
Endoscopic findings: Perianal skin tags and perianal
fistula, stricture at ileocecal valve, 5 mm polyp in cecum,
erythematous mucosa in rectum and sigmoid colon


"Tubular adenoma or adenomatous polyp - These are the most common type of polyp and are the ones referred to most often when a doctor speaks of colon or rectal polyps; about 70% of polyps removed are of this type. Adenomas carry a definite cancer risk that rises as the polyp grows larger. Adenomatous polyps usually cause no symptoms, but, if detected early, they can be removed during a colonoscopy before any cancer cells form. The good news is that polyps grow slowly and may take years to turn into cancer. Patients with a history of adenomatous polyps must be periodically reexamined.


More polyp types can be found at the Colon Cancer Alliance.

Basically, the pathologist found no evidence of cancer.  Based upon my Crohn's and polyp, the doc recommended performing another colonoscopy within 2 years.

The comments section is consistent with Crohn's Disease but is not diagnostic of Crohn's Disease - meaning the pathologist can't declare that what he saw MUST be Crohn's Disease, however, it is typical of Crohn's Disease.

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