PMC6431470_01
(a) Hyperaemia and diffuse superficial ulcerations of left colon. (b), (c), and (d) The giant pseudopolyp in the cecum with a normal colonic mucosa.
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On January 2018, after 13 years of initial diagnosis and while she was clinically asymptomatic, a screening colonoscopy for colorectal cancer showed diffuse superficial ulcerations surrounded by an erythematous inflamed mucosa from the rectum to the splenic flexure (Figure 1(a)), a solitary sessile well circumscribed polyp in the cecum with normal adjacent mucosa, not amenable to endoscopic resection (Figures 1(b), 1(c), and 1(d)).
(a) Polypoid structure formed by disorganized and rarefied glands and crypts in an inflammatory and edematous lamina propria. (b)-(c) Inflammatory lamina propria and rarefied glands. (d) Cryptitis: exocytosis of polynuclear neutrophils in the glands.
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Complete resolution of cecal GIP after 8 months of adalimumab therapy.
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Eight months later, a surveillance colonoscopy showed complete regression of the giant pseudopolyp (Figures 3 and 4) with partial endoscopic remission of the previously noted inflammation of rectum and sigmoid.
Desquamation and damage to the surface epithelium. Architectural distortion: duplication of crypts and irregular glands of varying sizes. Inflammatory infiltrate formed by neutrophils and plasmocytes in the lamina propria.
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Eight months later, a surveillance colonoscopy showed complete regression of the giant pseudopolyp (Figures 3 and 4) with partial endoscopic remission of the previously noted inflammation of rectum and sigmoid.