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A widely used adjective referring to an appearance, morphology or pattern characterised by multiple, similarly-sized rounded densities that project from a single linear surface when the image is 2-D or that rise above a flattened plane when viewed in 3-D, a pattern which has been likened to pre-infernal combustion engine roads paved with ‘cobbled’ stones
Dermatology A term which referred to a common complication of pre-1990 hair replacement surgery—now of historic interest—in which the grafts are bumpy, and do not flatten with time; it is more common in patients with a tendency to form hypertrophic scars. See Hair replacement
Gastroenterology A characteristic radiologic and gross appearance of the intestinal mucosa in Crohn’s disease, due to submucosal involvement; to the endoscopist, cobblestoning refers to the uniform nodules—due to the submucosal edema—while the pathologist refers to severe ulcerative disease with crisscrossing of the ulcers through inflamed but intact mucosa; intestinal ‘cobblestoning’ may also occur in ulcerative colitis—where ulcers alternate with regenerating mucosa, ischaemic colitis, lymphoid hyperplasia of CVID, amyloidosis, mucoviscidosis, pneumatosis cystoides intestinalis, multiple lymphangiomas, and polyposis coli; in the intestine, the mucosal rugosities may correspond to polyps, or be filled with air, lymphoid tissue or amyloid
(1) A term referring to a rare roughened appearance seen by colposcopy of a uterine cervix with Neisseria gonorrhoeae
(2) A finding by hysterosalpingography characterised by rounded filling defects due to intraluminal adhesions
Imaging A term referring to a bumpiness of the greater curvature of the stomach, a finding typical of chronic hypertrophic gastritis
Oral disease A term referring to multiple, closely-set intraoral papilloma-like fibromas that impart a pebbly tactile sensation in Cowden’s premalignant multiple hamartoma syndrome
Ophthalmology Multiple sharply demarcated non-elevated lesions with prominent choroidal vessels, located between the ora serrata and equator, seen in peripheral chorioretinal atrophy, common in ageing, seen in one-fourth of all autopsies, one-third of which are bilateral; aka paving stone degeneration, senile halo
Soft tissue pathology Multiple ‘hobnail’ projections of malignant endothelial cells into the vascular lumina seen in angiosarcoma, a pattern mimicked by Kaposi sarcoma and spindle cell hemangioendothelioma