S1736 The Pillow Sign: Is It Always Benign?

Ovary unusual colonic lesion

“…It can enlarge to 15–30 mm before release of the ovum, and several other gynecological pathologies may present as a colonic lesion including endometriosis, tubo‐ovarian abscess, and ovarian malignancies 5 . The finding of a pathognomonic cushion or pillow sign (the indenting of the extra‐colonic lesion with biopsy forceps pressure) is purported to represent a soft lesion, thus reducing the chance of malignant origin—though such an approach may incorrectly classify softer malignant lesions as colonic mucosa associated lymphoid tissue (MALT) lymphomas 7 . Further approaches used to classify submucosal lipomas include the naked fat sign (the endoscopic finding of extrusion of underlying yellowish fatty materials after repeated biopsies) and tent sign (rise of mucosa over the lipoma with the biopsy forceps).…”