Polypectomy scar

A polypectomy scar results from a polypectomy.

General

• Scar alone is difficult to differentiate from scar with cancer.

• Iatrogenic tattoos are commonly seen in the context of polypectomy scars. Unfortunately, endoscopists are not good at documenting them; a study from 2021 found 67% of the time the location of the tattoo is not documented.

Gross

• Flat white regions with loss of the usual mucosal folds.
• Usually seen in association with an iatrogenic tattoo.

Note:

• The tattoo is most often distal to the scar.

Microscopic

Features:

• Focal submucosal fibrosis.

DDx:

• Polypectomy scar with adenocarcinoma.
• Focal fibrosis due to other cause.

Images

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  CPR - extremely low mag. (WC)

• 

  CPR - very low mag. (WC)

• 

  CPR - low mag. (WC)

Sign out

Should be signed in a non-committal way (e.g. "focal submucosal fibrosis") if no prior pathology is available/specimen is not labelled something like "old polypectomy site".

The location of any intragenic tattoo(s) should be documented in relation to the suspected scar and correlated with clinical information (if available).

Right Colon, Terminal Ileum and Appendix, Right Hemicolectomy:
	- Benign mucosal/submucosa scar compatible with the polypectomy site, correlation recommended, see comment.
	- Iatrogenic tattoo.
	- Terminal ileum within normal limits.
	- Appendix within normal limits.
	- Twenty benign lymph nodes (0 positive/20).
	- NEGATIVE for dysplasia and NEGATIVE for malignancy.

Comment:
The scar was submitted in total.  The location of the scar in relation to the tattoo is documented within the gross. 

It would be useful to confirm that: the location of lesion (that prompted the resection) in relation to the tattoo is the same as the relationship between scar and the tattoo.  

See also

• Polypectomy.
• Iatrogenic tattoo.