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Disappearing polyp and low grade dysplasia

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Ulcerative Colitis
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Posted 6/28/2017 9:03 PM (GMT 0)
Just wondered if anyone had experienced a similar situation to this. 6 months ago I had a routine colonoscopy and the pathology report showed an apparent polyp and small area of,low grade dysplasia with possible adenoma. The GI medic suggested a follow up colonoscopy in 6 months which I have just had. He could not find the polyp nor any sign of low grade dysplasia during the colonoscopy. I will get the lab results next week but want to be prepared as he said if anything shows up I would require a surgical operation as there is nothing visible which he can remove during a colonoscopy. I know low grade dysplasia may turn high grade and cancerous with higher risk the longer you have UC (35 years with current remission of 13) but it seems very radical to me to operate when nothing is visible. I have thoughts like how would the surgeon even know he was removing the correct area when he can't see anything. I guess my questions are - can a polyp and dysplasia disappear. Might the first lab report have been wrong. Should I be agreeing to an operation on the basis of a lab report and no visible evidence?
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Female 68. Currently on Salofalk enemas and Macrogol. Came off mercaptopurine 4 months ago and started the Salofalk, so far so good.
Posted 6/28/2017 9:51 PM (GMT 0)
That's a tough situation and I don't know what I would do. I know things can be missed when doing a scope, but I am sure they were careful to check thoroughly considering your past result. If the pathology comes back showing dysplasia, regardless of what was seen, it needs to be taken seriously. You could potentially continue to monitor, but you could end up in the same shoes in a year, or two, or five. Surgical procedures do not get any easier with age, they only get more difficult and recuperating gets more difficult, but it is a big procedure, with results that can change your daily life, so you need to be 100% sure it is what needs to be done. Have you gotten any other opinions? I would imagine they would take the whole colon considering the UC and dysplasia. You will have to ask the plan if it comes to that... i don't know how I would feel about the scope showing nothing. Of course it's great to think *maybe* you've got a clean bill of health, but then at the same time, maybe something was missed and it's lurking. I'd definitely want a recheck sooner than later. Why did they leave the polyp there? usually they would remove it during the scope... i had one once and they took it off and sent for pathology.
Posted 6/28/2017 11:46 PM (GMT 0)
I'd get a Chromoendoscopy the next time, it's a bit more precise with a dye that'd make cancerous and dysplasia standout.
Posted 6/29/2017 6:28 AM (GMT 0)
Thanks for your replies. The colonoscopy procedure I had had white light and narrow band imaging and specialist said that should show up anything. He was as puzzled as me as he didn't see anything the first time either. His report this time said "could not see any macroscopic abnormality to account for low grade dysplasia in previous biopsy". He could not find any trace of the polyp either. The original pathology report said "careful clinical pathological correlation is required". Would this suggest pathologist wasn't sure either? Since GI specialist didn't find anything it can't be correlated can it and I am wondering how I would feel about an operation in these circumstances as his last words to me were if same result an operation would be required if nothing shows further colonoscopy in 9 months. I don't know if this throws any further light on whether the pathology may not have been correct rather than the GI specialist. I also am not very good at thinking on the spot in a doctors consulting room and wondered what questions I should be asking if it does come back with a similar report.
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