Colonoscopy revealed a LST-G of approximately 30 mm in diameter in the lower rectum. (a,b) The lesion consisted of not only aggregated small and large nodules typically seen in LST-Gs, but also hardly elevated flat parts. (c) Magnifying chromoendoscopy after 0.4% indigo carmine dye spraying showed a type IIIL pit in the small nodules and a type IV pit in the larger ones, whereas dilated round pits were observed in the hardly elevated flat part. (d) Three months later, the nodules that had increased in height and size shows a type IV pit pattern, and a type IIIL pit was seen in the flat area that had increased in height; (e) however, the dilated round pits have decreased in number in the flat area. LST-G, granular type laterally spreading tumor.