Conclusion: Our case is a rare example of a colonic inflammatory fibroid polyp treated successfully with a combination of argon plasma coagulation, endoclipping and polypectomy. We know we are lead in our ICD 10 manual to code them as part of the transverse colon under the code D12.3 but does anyone else use a different location code for these two areas. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm. However IFP is a benign lesion that does not metastasize and very rarely recurs therefore the number of IFPs resected endoscopically will probably increase in the near future. 1 We are a group of gastro coders and was wondering if anyone has any information as to splenic and hepatic flexure polyp removal codes. ICD-10-CM C18.3 Malignant neoplasm of hepatic flexure Neoplasms ( C00-D49) Note: Functional activity All neoplasms are classified in this chapter, whether they are functionally active or not. In the past, surgical excision was the main treatment of choice for colonic IFPs because tumor size is relatively large and often could not be differentiated from malignant polyps macroscopically or pathologically. Endoscopically, IFPs have a smooth sessile or pedunculated configuration and most have an erythematous or ulcerative mucosa. Negative staining for c-kit helps to distinguish IFPs from GISTs and solitary fibrous tumor. These findings are consistent with a histopathological diagnosis of inflammatory fibroid polyp. The spindle cells were positive for CD34 and S100 but negative for c-kit and muscle markers. Proliferation of spindle cells and infiltration of inflammatory cells such as plasma cells and eosinophils were observed. Histologically the polyp was located in the submucosa of the gastrointestinal tract. After these measures we were able to resect the stalk with the hot snare and the polyp was retrieved. Want to know more about Dexurs Capabilities Get In Touch C182, Malignant neoplasm of ascending colon C183, Malignant neoplasm of hepatic flexure C184. We placed an endoclip at the base of the stalk, and then applied argon plasma coagulation at 1.0 liter/minute and 40 watts. However the polyp stalk was extremely difficult to resect despite several attempts with the hot snare. A saline injection-lift technique using a hot snare was attempted to remove the polyp. A 12mm pedunculated polyp was found at the hepatic flexure of the colon. Case: A 74 year old asymptomatic female underwent a screening colonoscopy in our hospital. We present a rare case of a pedunculated inflammatory fibroid polyp in the hepatic flexure of the colon. Histologically an inflammatory fibroid polyp is characterized by a mixture of numerous small vessels, fibroblasts and edematous connective tissue associated with marked inflammatory infiltration by eosinophils. Most occur in the stomach and colonic occurrence is very rare. Purpose: Inflammatory fibroid polyp (IFP) is a rare benign polypoid lesion of the gastrointestinal tract.
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