Editor,—We read with great interest the article by Martin et al (Gut1999;45:147) on normal histological findings in small depressed lesions of the large bowel. They described three patients with 7–8 mm depressed rectal lesions, similar to small flat or depressed neoplastic lesions, during sigmoidoscopy (two cases) and total colonoscopy (one case). Specimens taken by extensive biopsy or removed by endoscopic mucosectomy were histologically normal with no evidence of neoplasia. Two weeks later, colonoscopy with chromoscopy in one patient failed to locate the lesion. In contrast to true flat adenomas characterised by rough, reddened central mucosa and an irregular outline, the lesions had normal central mucosa and a regular circular elevation. The authors therefore concluded that flat …

Dr J Martin (email:jplmartin{at}aol.com)

Dr J Martin (email:jplmartin{at}aol.com)