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. 2024 Jul 25;12(7):E924–E931. doi: 10.1055/a-2350-9631

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The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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Fig. 5 — Microscopic examination of the resection specimen containing a, b chicken skin and c,d green sign. Macrophagic infiltration with xanthomatous morphology (black arrow in a ), as previously described in other studies. Increased number of lymphoid nodules at the periphery of invasive carcinoma (black arrow in b ) corresponding to a hyperplastic reaction of the gut associated lymphoid tissue, which could at least partially explain the chicken skin with regularly scattered small nodules lifting the mucosa. Thinning of the mucosa (dotted double arrow in c ) compared with the adenomatous mucosa (double arrow in c ) as invasive glands destroy the mucosa. Destruction of the muscularis mucosae (black arrow in d , in red) by invasive glands which may contribute to the increase in the hemoglobin detection signal, resulting in the green sign.