Bleeding polyps?


Question: A 60-yearold Caucasian woman presented with melena of 3 days’ duration. It was the second episode of gastrointestinal (GI) bleeding. Fourteen days ago, colonoscopy done in another hospital revealed diverticulosis and 3 small polypoid lesions in the cecum without signs of acute bleeding. Biopsies of the lesions have been taken. Gastroscopy was normal. At admission to our hospital, the patient was hemodynamically stable. Laboratory findings showed hemoglobin level of 80 g/L (normal limits, 121–154 g/L) and thrombocytes of 34 g/L (normal limits, 140–380 g/L). The patient had a history of multiple myeloma stage IIA, immunoglobulin (Ig)G kappa type diagnosed 10 years earlier. As treatment she had received stem cell therapy, interferon alpha, thalidomide, and velcade. At the time of admission, she was under chemotherapy with lenalidomid (15 mg/d) and dexamethason 40 mg/d. Repeat colonoscopy revealed confirmed diverticulosis. In addition, 4 subepithelial protruded lesions with central depression and marked vessels without acute bleeding in the cecum and colon ascendens were detected. The diameter of the lesions was between 4 and 10 mm (Figure A, B). What is the etiology of the lesions? See the GASTROENTEROLOGY web site ( for more information on submitting your favorite image to Clinical Challenges and Images in GI. Conflicts of interest: The authors disclose no conflicts. © 2012 by the AGA Institute 0016-5085/$36.00 doi:10.1053/j.gastro.2011.03.065

DOI: 10.1053/j.gastro.2011.03.065

Cite this paper

@article{Wilhelmi2012BleedingP, title={Bleeding polyps?}, author={Martin Wilhelmi and Pablo Mu{\~n}oz and Marianne E J Ortner}, journal={Gastroenterology}, year={2012}, volume={142 2}, pages={e21-2} }