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flat adenomas vs lymph tissue?
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flat adenomas vs lymph tissue?

I had a colonoscopy 2 days ago for mild rectal bleeding and pain.  I am a healthy and active 43 yo female.  My doc found multiple flat adenomas throughout my entire colon of which she took several biopsies.  During the procedure she told me that if the adenomas were PRE-cancerous I would need a total colectomy as my colon was a hotbed of activity and it would be too risky to leave in.  She said it was possible that the adenomas were only lymphatic tissue in which case I am not sure of the treatment plan.  Being a critical care RN for over 20 years I hit the internet to research as best I could to prepare myself.  I was awake and able to see the biopsies taken and noticed also that the lesions/adenomas were flat and looked grayish in color.  I see that the flat adenomas have a significantly higher rate of being pre-cancerous.  Needless to say I am crawling the walls waiting for the biopsy results.  I have found tons of info on the flat polyps/adenomas/lesions but can find next to nothing about the lymphatic tissue lesions which is the other (and I am hoping benign) possibility according to my doctor.  
Is there a benign explanation for the multiple adenomas/lesions found throughout my colon?  
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Avatar_m_tn
Hi there.

These flat lesions are indeed most likely adenomas since lymph structures presenting this way is quite extraordinary.  These flat adenomas are likewise more prone in harboring or eventually developing into cancer compared if these are pedunculated polyps.

Though the biopsy results would definitely tell us the nature of these lesions, I agree with your doctor that you may be at high risk for developing cancer in the future and several steps may be taken to decrease this risk (including surgery and medications such as Aspirin and other NSAIDS).

Regards and God bless.
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Avatar_m_tn

Hi - if the eventual medical recommendation is "surgery" then, in order that you have some understanding of the experience, you might like to log on to a posting where I described my own experience of a total colectomy - although in my case it was for torrential diverticular bleeding.

Log on to:-

http://www.medhelp.org/posts/show/523166

At the appropriate time you may wish to print off this posting and show it to your surgeon in order to check whether their prediction marries up with my own recollections.

Good luck

regards
Morecambe
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Avatar_f_tn
Thank you so much for responding to me.  

My physician called my husband last eve to report that the bx results were negative and not to worry.  I was at work but have been told to call her later today if I wish to talk about the results.  She told my husband that the "spots" were just an indication that I have a  "very strong immune system".

I have done all the research I can this morning to see exactly what she might mean by those statements so that I can ask all the appropriate questions and am not coming back with much that makes sense.  I have not been told the exact wording of the bx yet but will ask for that when I speak to her.

Colonic lymph follicles are usu not endoscopically viewed according to what I can find-at least not in adults except in the presence of melanosis coli.

Lymphoid hyperplasia is usu a response to infection, allergy or immune deficiencies (AIDS, Crohns or hypogammagloulinemia-non of which I have).  Could the hyperplasia be a response to the bowel prep itself???  I did not have any symptoms of an infection of any sort at the time I had the test and have no immune deficiencies.  I do have some mild allergies/asthma for which I take Singulair qd.  

I just want to make sure I ask all the right questions of her when I speak to her later today.  I am just not comfortable knowing I have all of these polyps/lesions/spots (sorry....not sure what to call them now) in my colon and doing nothing.  Maybe a second opinion?

Have you heard of this?  

Thank you so much!
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Avatar_f_tn
Well this is what I gleamed from my short phone call with my doctor:

- didn't have the report in front of her but they were "lymphoid follicles"
- all the bx results were the same (approximately 5-6 were done)
- there were possibly hundreds of these noted on my colon
- yes, they are rarely seen during colonoscopies but it is nothing to worry about
- why were mine visible?  "That's just your bowel.  That's just you.  They may always be there or you may have recently been fighting an infection."
- were they a response to the bowel prep?  "Possibly"
- do I need another colonoscopy anytime before the average citizen needs to start having them for surveillance?  "No"  I am only 43 so have many years to go until I officially need one.  Or do I?  Father has had several pre-cancerous ones removed but has been clear for years now.

I forgot to ask her if she has seen them before in the colon as everything I read says they should not be visible except in the instances I noted before in my previous post.  She did say they are typically seen in the cecum and ileum.

Should I just let this go or get a second opinion?

Thank you!
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