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Posted 1/15/2011 12:48 AM (GMT 0)
tell me what you guys think. gi doc says this is as gray as a gray area can get and that i'm basically rolling the dice as far as choosing between frequent colonoscopies for the forseeable future or just getting my colon taken out:

FINAL DIAGNOSIS:

A. COLON, SITE NOT OTHERWISE SPECIFIED, RANDOM ENDOSCOPIC BIOPSY:

- ACTIVE CHRONIC COLITIS. SEE COMMENT.

B. RECTUM, ENDOSCOPIC BIOPSY:

+ - FRAGMENTS OF ADENOMATOUS EPITHELIUM WITH TUBULOVILLOUS ARCHITECHTURE.

- FRAGMENTS OF COLONIC MUCOSA WITH ACTIVE CHRONIC COLITIS.

SEE COMMENT.

C. RECTUM, "BORDER OF POLYP," ENDOSCOPIC BIOPSY:

- ACTIVE CHRONIC COLITIS.

COMMENT "A":

Some of the fragments submitted show reactive glands involved with

cryptitis and crypt abscesses. Other pieces show rare glands with

architectural distortion (branching and fore-shortening) and are largely

not involved with the acute inflammatory process. There are numerous

reactive lymphoid follicles. Granulomas are not observed.

COMMENT "B":

The numerous fragments submitted show dysplasia with both tubular and

+ villous architecture consistent with tubulovillous adenoma. The material

submitted shows complex architecture with branching and fronding as

expected for a polypoid lesion. Nevertheless, in a young patient with IBD,

polypoid dysplasia is known to occur and to have much more serious

ramifications. In light of this observation, the case will be forwarded

to Stanford University in consultation to obtain an expert opinion. An

addendum regarding the consult findings will be published at a later date

as an addendum.

should i just get the thing taken out so i don't have to worry about ever developing cancer in light of these findings?

Posted 1/15/2011 1:01 AM (GMT 0)
My 2 cents - Stanford is good but not the best. I'd repeat the colonoscopy at Mayo (MN), Cleveland, or Hopkins. I redid mine at Hopkins last week and they refuse to use any other labs and biopsy places outside their facilities. The GI postdoc fellow told me that sometimes there is a big difference in the training and experience of the person that analyzes the samples. These 3 places hire the best of the best and there is a huge competition to get to work for them. Get a second opinion before deciding on the surgery.
Posted 1/15/2011 1:06 AM (GMT 0)
well i'm in the air force so i'm pretty much limited to the docs/surgeons in the military, unless i want to pay for it all myself. thinking that would be pretty pricey haha. i just thought that having an adenoma in an area of inflammation could be explained by the colitis. i dunno. i guess i'm just scared to go through the surgery and get a j-pouch with frequent poos.
Posted 1/15/2011 8:04 AM (GMT 0)
I think it's more serious than not....there's definite changes on a level other than UC inflammation.

what about elsewhere in your colon...were there any other biopsies taken?

q
Posted 1/16/2011 12:10 AM (GMT 0)
The random biopsies fall under comment A. Not sure what all that means. Young people do get polyps, they just don't know if this is one of those sporadic polyps or something else.
Posted 1/16/2011 5:21 AM (GMT 0)
Seems either the nurse or doctor weren't fussy about placing the biopsies..but all say active and chronic...so specific changes are noted in the cell formation.
No dysplasia, that's good.

Was the entire polyp removed plus the area around it? or just a part of the polyp?

Some info/pics on cryptitis/crypt abscesses:

http://www.pathguy.com/~tdemark/0068.htm

I got this excert from the site listed underneath it:

The architecture may be tube-shaped, villous, or tubulo-villous. Basement membrane plus muscularis mucosae are complete. PATIENTS AND METHODS: Hospital charts as of 30 patients who underwent surgical treatment of colorectal tubulovillous adenomas between 1980 plus 1997 were on reflection reviewed. RESULTS: Rectal bleeding, urgency plus secretion discharge were the most frequent clinical findings. Villous adenoma or tubulovillous adenoma - about 15% of polyps removed are of this type. These are the most serious type of growth with a very high cancer risk as they grows superior.

http://www.vitasource1.com/information2/treatment-of-vilous-adenoma.html

 

My opinion...you need to do serious research and I agree with your doc about the probable outcome.   Personally and with absolute and sincerest honesty...my colon would be out pronto.

 

yes, young people get polyps...yours isn't pseudo polyp related to UC.  The fact that you're young has the urgency in my opinion.

But...remember, this is only my opinion regarding your now-not-so-personal butt. ;-)

q

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