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The Old Endoscopy Quiz (and Answer) of the Month
October 2002

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Question:

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These images show an advanced colorectal carcinoma seen in the first two images to the left and in the third image in the upper part of the picture.. In the visinity of the tumour there is a slight whitish mucosal pigmentation. This is not an infrequent finding. What might be the cause of this slight pigmentation?

Answer

Colonic chicken skin mucosa.

These slight mucosal changes are frequently seen adjacent to a colorectal cancer or adenoma. First described by Shatz BA et al, they are called Chicken Skin Mucosa (CMS), and are supposed to occur as a result of fat accumulation in macrophages in the lamina propria adjacent to colonic neoplasms. In a series of 852 consecutive colonoscopies CMS was found adjacent to eight of 10 distal colorectal cancers, one of four of proximal colon cancers and 16 of 42 distal adenomas.

Reference:
Shatz BA, Weinstock LB, Thyssen EP, Mujeeb I, DeSchryver K: Colonic chicken skin mucosa: an endoscopic and histological abnormality adjacent to colonic neoplasms. Am J Gastroenterol 1998 Apr;93(4):623-7

Answers and comments were emailed by

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Ervin Toth, Malmö, Sweden
PARABOLI SILVA, Marcio Luiz, CAMPO MOURAO-PARANA- BRAZIL
Nazlıgül, Ankara, Türkiye (Turkey)
Yaşar Nazlıgül, Ankara, Türkiye (Turkey)
Chalhoub Wissam, Beirut, Lebanon
Radwan Zahreddine, Beirut, Lebanon
Ignacio Hanna, Guayaquil, Ecuador - Hi Hanna Ignacio, havent heard from You for a Long time!
kubilay cinar, Ankara, Turkey

Beirut, Lebanon

Elie Choueiry, Beirut, Lebanon
Claudia Ludwig, Vienna, Austria
Klaudia Niepsuj, Bytom, Poland
dr.bhagwan s.thakur, Mumbai, India
Dario Gambaccini, Livorno, Italy
ATAKAN SEZER, EDİRNE, TURKEY
Yekta Kisioglu, Istanbul, Turkey
Farouq Yassin, Columbia, USA

Comments:

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