In 30 cases of colonic neoplasia associated with melanosis coli, proliferating or neoplastic colonic epithelium was notable within the melanotic colons by virtue of a striking absence of pigmentation. Microscopically this characteristic was found to be due to an absence or diminution of pigment-laden macrophages in the lamina propria underlying such lesions. Therefore, the absence of pigment-laden macrophages can be considered a marker for abnormally proliferating epithelium. This characteristic may denote a cellular or humoral change mediated by macrophages in association with neoplastic epithelium.