This ASG video tip is brought to you by an educational grant from Braintree, a part of Cibela Pharmaceuticals, makers of SUTAB. This patient is a 46 year old woman who is undergoing screening colonoscopy for a family history of colon cancer in an older first degree relative. We are in retroflexion in the rectum. You can see the scope and the dentate line. The lesion is being examined first in white light and now in narrow band imaging. We also have the near focus on to examine this lesion. The correct answer is condyloma. The clues of course are the location, typically the vicinity of the dentate line. They can span the dentate line, be only on the squamous mucosa, or they can be up in the rectum. They have a characteristic appearance. I think MBI is very useful. The background of the lesion is typically white and there's no real discernible pit structure but there is a fine pattern of lacy vessels over the surface of the lesion and those are the clues. When you identify these, I usually will take a biopsy sample to confirm the diagnosis and then refer the patient to whoever manages these lesions whether you do it yourself, your colorectal surgeons, if they're on the perianal skin, sometimes the dermatologists are involved in treatment of these lesions. The bottom of the lesion has that characteristic white background with thin lacy vessels but no real pit structure to the lesions. Here is another one. This one is spanning the dentate line. Again, when we look at it in narrow band imaging, we can see that background white pattern, no real pit structure and then this white lesion is crisscrossed with these small thin lacy vessels, the typical appearance and location of condyloma.

dentate line

colonoscopy

condyloma

biopsy confirmation

screening