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January 28, 2019

Image challenge: Atypical colonic polyp

What caused a homogeneous polyp with soft tissue attenuation and no fat attenuation to develop in a 71-year-old, asymptomatic man?

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Gastroenterology clinical image challenge: A 71-year-old, asymptomatic man underwent incomplete colonoscopy for screening. He had a history of surgically resected retroperitoneal well-differentiated liposarcoma 10 years prior, with local recurrence as dedifferentiated liposarcoma six years later. Physical examination and laboratory tests were unremarkable. He underwent computed tomography colonography (CTC) to evaluate the colon segments not assessed by conventional colonoscopy. The CTC demonstrated a 3-cm pedunculated polyp in the ascending colon on the supine acquisition and on three-dimensional endoluminal view (figure). The polyp was homogeneous and showed soft tissue attenuation, with no fat attenuation.

What is the diagnosis?

To find out the diagnosis, read the full case in Gastroenterology or download our Clinical Image Challenge app through AGA App Central, which features new cases each week. Sort and filter by organ, most popular or favorites. AGA App Central is available in both the Apple App Store and Google Play.

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