Rectum

A retrograde view of the distal rectum demonstrating diffuse verrucous mucosal changes.

91 year old female presented with rectal bleeding for which she underwent colonoscopy. Biopsy study from the distal rectum demonstrated diffuse villous adenoma with focal high-grade dysplasia. EUS and CT studies were negative. Due to advanced age, a conservative treatment was elected. However, EMR demonstrated foci of well-differentiated adenocarcinoma and high-grade dysplasia without lymphovascular invasion.

A close-up view of the distal rectum, demonstrating normal mucosa (left half of the image), compared with diffuse verrucous flat mucosa of the distal rectum (right half of the image).