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Endoscopic submucosal dissection of an unusual flat rectal neoplasm
  1. Francesco Azzolini1,
  2. Paolo Cecinato1,
  3. Veronica Iori1,
  4. Loredana De Marco2,
  5. Ramona Zecchini1,
  6. Cristina Fodero3,
  7. Cristiana Tioli1,
  8. Romano Sassatelli1
  1. 1Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
  2. 2Unit of Pathology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
  3. 3Cervical Cancer Screening Centre, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
  1. Correspondence to Dr Francesco Azzolini, Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, 42123, Italy; francesco.azzolini{at}asmn.re.it

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Clinical presentation

A 63-year-old woman was admitted to our gastroenterology unit to undergo a screening colonoscopy, scheduled for faecal occult blood test positivity. During the procedure, a flat, rectal granular lesion was found. With the use of magnification and narrow band image (NBI) technology, the lesion was diagnosed as a laterally spreading tumour (LST), granular mixed type, 30 mm in maximum diameter (figure 1). The pit pattern was unclassifiable and vascular pattern was similar to the type IV of the classification proposed by Inoue regarding the microvasculature pattern of the oesophagus for diagnosis and evaluation of the squamous cell carcinoma. The …

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