1 COLON 3 Part Case

A 53-year-old male presented with bowel habit change and significant weight loss for 3 months. Physical examination revealed an ill-defined mass at right lower abdomen. His stool examination was normal. Colonoscopy was performed and revealed multiple friable polypoid masses with erosions and white debris on top at the cecum (Figures 1 and 2). Blue laser imaging endoscopy (BLI) showed mucosal inflammation (Figure 3). Ileocecal valve was markedly swelling and causing narrowing of the lumen precluding the passage of a colonoscope into the terminal ileum; however, the remaining colon was normal. Biopsy was done at the mass. Histopathology showed foci of granulomatous inflammation with focal caseous necrosis, and aggregated epitheloid histiocytes (Figure 3). Tissue AFB and PCR-TB were negative.