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Chang and Park: A rare colonoscopic finding in a renal transplant recipient


A 50-year-old male visited Severance Hospital for colonoscopy screening without any specific symptoms. He received an allogeneic renal transplantation 20 years prior and had no associated complications. He had undergone a colonoscopy three years previously, and there were no abnormal findings. Physical examination revealed no remarkable findings. Blood test results were within normal ranges. Colonoscopy revealed multiple whitish, flat, or slightly elevated mucosal lesions measuring 10 to 20 mm in diameter in the ascending colon. The pit pattern of these lesions was not compatible with that of typical adenomas, and forceps biopsies were preformed at each portion (Fig. 1). Histological findings and immunostaining results for CD68 (PG-M1), are shown in Figure 2. What is the most likely diagnosis?


Conflicts of Interest
Ji Young Chang is currently serving in the KSGE Publication Committee member in Clinical Endoscopy; however, she was not involved in the peer reviewer selection, evaluation, or decision process of this article. Soo Jung Park has no potential conflicts of interest.
We would like to thank the staff involved in endoscopic retrograde cholangiopancreatography at the participating institutions.
Author Contributions
Conceptualization: SJP; Writing–original draft: JYC; Writing–review & editing: all authors.

Fig. 1.
Colonoscopy with the use of (A, B) white light and (C, D) narrow-band imaging revealed multiple whitish flat or slightly elevated mucosal lesions measured 10 to 20 mm in diameter at the ascending colon.
Fig. 2.
Histopathologic findings. (A) The lesions consisted predominantly of histiocytes with eosinophilic granular cytoplasm (von Hansemann cells) (arrow) (hematoxylin and eosin stain, ×200). (B) The lesion was positive for CD68 (PG-M1, ×400).
Fig. 3.
(A, B) Colonoscopy following after 6 months of antibiotics treatment shows complete resolution of all lesions.


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