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Baccouche C, Ayari M, Abdelaali I, Dhaoui A, Jomni T, Douggui MH. Endoscope disinfectant-induced colonic pseudolipomatosis: case series of a rare condition. Future Sci OA 2024; 10:FSO985. [PMID: 38869427 PMCID: PMC11172253 DOI: 10.2144/fsoa-2023-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/28/2024] [Indexed: 06/14/2024] Open
Abstract
Aim: Colonic mucosal pseudolipomatosis is a rare and benign endoscopic finding with distinct macroscopic and histological characteristics. Case series: We observed a form of unprecedented colitis in eight patients in a 3-month period. Operators have found, during colonoscopy, flat or slightly raised whitish-yellow plaques, in the colonic mucosa of all patients. Histological examination concluded to pseudolipomatosis. After investigation, the disinfectant machine was found to have technical malfunctioning of the rinse cycle of the endoscope during this period. No other cases were observed after the machine was fixed. Conclusion: Pseudolipomatosis is more an endoscopically induced lesion than a true pathological condition. A careful check of the disinfection process should be carried out when such lesions are detected.
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Affiliation(s)
- Charfeddine Baccouche
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Myriam Ayari
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Imen Abdelaali
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Amen Dhaoui
- Pathology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Taieb Jomni
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Mohamed Hedi Douggui
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
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Valencia Deray KG, Kellermayer R, Gomez AC, Patel KR, Imani P, Kitagawa S, Bocchini CE, Orjuela A. Colonic malakoplakia in a pediatric renal transplant recipient case report. SAGE Open Med Case Rep 2024; 12:2050313X241239866. [PMID: 38505578 PMCID: PMC10949541 DOI: 10.1177/2050313x241239866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/28/2024] [Indexed: 03/21/2024] Open
Abstract
Malakoplakia is a rare, chronic granulomatous disease that mainly affects the genitourinary system of immunocompromised adults. It is caused by a bactericidal deficit in macrophages and, therefore, the treatment includes antimicrobials that reach high concentrations in macrophages. To our knowledge, we present the first case of malakoplakia in a pediatric solid organ transplant recipient. Our patient is a 15-year-old male renal transplant recipient who presented with recurrent diarrhea. Blood, urine, and gastrointestinal pathogen panel testing were positive for enteroaggregative Escherichia coli. A colonoscopy revealed diffuse malakoplakia. He had a complete resolution of symptoms with trimethoprim-sulfamethoxazole therapy. Unfortunately, his malakoplakia recurred after 9 months prompting the transition of therapy to oral gentamicin with subsequent remission. Malakoplakia should be considered in the differential of solid organ transplant recipients with recurrent gastrointestinal infections.
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Affiliation(s)
- Kristen G Valencia Deray
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Richard Kellermayer
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Alexis C Gomez
- Division of Pediatric Nephrology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, USA
| | - Kalyani R Patel
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Peace Imani
- Division of Pediatric Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Seiji Kitagawa
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Claire E Bocchini
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Alvaro Orjuela
- Division of Pediatric Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Liu X, Yu C, Zhao Z, Zheng Y, Chen X, Zhou D. Rectal malakoplakia mimicking advanced rectal cancer: A case report. Heliyon 2023; 9:e20780. [PMID: 37842623 PMCID: PMC10568101 DOI: 10.1016/j.heliyon.2023.e20780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/17/2023] Open
Abstract
Background Malakoplakia is a rare acquired chronic infectious granulomatous condition, that is characterized by the accumulation of large granular macrophages containing basophilic inclusion bodies in the cytoplasm termed Michaelis-Gutmann (MG) bodies. Malakoplakia most commonly involves the genitourinary system, and the second most commonly affected site is the gastrointestinal tract. Rectal malakoplakia is an unusual entity that is difficult to diagnose due to its diverse clinical manifestations and radiological findings that are similar to different diseases and advanced cancers. Case description A 61-year-old male patient presented with difficulty in urination and defecation that started 4 months prior, along with a weight loss of 10 kg. Abdominal computerized tomography (CT) scanning revealed diffuse lesions of the perirectal region with multiple lymphadenopathies and involvement of the bladder, prostate, bilateral seminal vesicles, and left ureter. 18F-FDG PET/CT MIP showed intense FDG uptake in the rectal region, and a diagnosis of an occupying lesion was proposed. Colonoscopy and histological examination of rectal lesion biopsies showed the characteristic features of malakoplakia. Conclusion Malakoplakia of the rectum with lymph node involvement and adjacent organ extension has been extensively misdiagnosed in clinical practice, and mimics malignancy radiologically. It is of great importance for radiologists to be aware of malakoplakia when making the differential diagnosis of benign and malignant mass lesions of the rectum, although the radiologic findings are nonspecific. Endoscopic evaluation and pathologic examination of a biopsy should be recommended to make the correct diagnosis, which may prevent unnecessary surgical resection.
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Affiliation(s)
- Xiangyu Liu
- Department of Radiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Chenming Yu
- Department of Interventional Radiology, Lishui District People's Hospital, Nanjing, China
| | - Zhuo Zhao
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, China
| | - Yiping Zheng
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Xin Chen
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Dandan Zhou
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
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Taher M, Shahsia R, Ebrahimi Daryani N. Malakoplakia as a Rare Cause of Diarrhea: Case Presentation and Review of Literature. Middle East J Dig Dis 2021; 13:71-74. [PMID: 34712442 PMCID: PMC8531935 DOI: 10.34172/mejdd.2021.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/13/2020] [Indexed: 11/28/2022] Open
Abstract
Colonic malakoplakia is a rare chronic granulomatous disease that can involve many organs such as the lung, brain, pancreas, bone, adrenal glands, and genitourinary tract. The most common site of involvement outside the genitourinary tract is the gastrointestinal tract. We report a case of colonic malakoplakia who presented with unintentional weight loss, abdominal pain, and chronic diarrhea. There was a history of lupus nephritis and Sjogren disease, receiving various immunosuppressive drugs. Physical examination other than pallor was unremarkable in this patient, but colonoscopy revealed multiple polyps in the rectum with a cobblestone appearance in the cecum. The histopathological assessment showed infiltration of numerous lymphoplasma cells and neutrophils in the lamina propria, and rare Michaelis-Gutmann bodies were seen in foamy epithelioid histiocytes. These findings are suggestive of malakoplakia. We treated the patient with tetracycline, and after 3 months of follow-up, clinical improvement was achieved.
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Affiliation(s)
- Mohammad Taher
- Assistant Professor of Gastroenterology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shahsia
- Associate Professor of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasser Ebrahimi Daryani
- Professor of Gastroenterology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Park JW, Baek DH, Lee SJ. Multiple Polypoid Lesions in the Sigmoid Colon. Gastroenterology 2020; 158:482-484. [PMID: 31560905 DOI: 10.1053/j.gastro.2019.09.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/16/2019] [Indexed: 12/02/2022]
Affiliation(s)
- Joon Woo Park
- Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Dong Hoon Baek
- Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - So Jeong Lee
- Department of Pathology, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Iwamuro M, Tanaka T, Kawabata T, Sugihara Y, Harada K, Hiraoka S, Okada H. Pseudolipomatosis of the Colon and Cecum Followed by Pneumatosis Intestinalis. Intern Med 2018; 57:2501-2504. [PMID: 29709952 PMCID: PMC6172536 DOI: 10.2169/internalmedicine.0730-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A 74-year-old Japanese woman was diagnosed with pseudolipomatosis of the cecum and ascending colon. Colonoscopy was performed, which revealed the presence of slightly elevated white lesions, while a magnifying observation showed microbubbles within the mucosa. A month after colonoscopy, the patient was diagnosed with pneumatosis intestinalis. Although the exact pathogenesis is unclear, pneumatosis intestinalis may arise secondary to pseudolipomatosis. This case also indicates that a magnifying observation during colonoscopy may aid in the diagnosis of pseudolipomatosis of the large intestine, since it shows microbubbles within the mucosa, which may be a distinctive feature reflecting the pathology of this disease.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | | | - Tomoko Kawabata
- Department of Rheumatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Yuusaku Sugihara
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Keita Harada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Sakiko Hiraoka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
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Yared RA, Badran HA, Kamareddine MH, Ghosn Y, Bou Khalil R, El Ajamy K, Chouairy C, Farhat SG. Colonic Malakoplakia: A Rare Finding in a Healthy Male. Case Rep Gastroenterol 2018; 12:453-456. [PMID: 30186099 PMCID: PMC6120369 DOI: 10.1159/000492208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/17/2018] [Indexed: 02/05/2023] Open
Abstract
Malakoplakia is a rare chronic granulomatous disease that may affect many organs, including the lung, brain, adrenal glands, pancreas, bone, and the genitourinary tract. The gastrointestinal tract is the most common site of involvement outside of the urinary tract. Herein, we present a case of a 65-year-old male who presented with abdominal pain and unintentional weight loss. Physical examination findings were unremarkable, but colonoscopy revealed an isolated large, flat, soft, and pale lesion in the transverse colon. Histopathological examination of the lesion showed expansion of the lamina propria due to numerous lymphocytes, plasma cells, neutrophils, and polygonal cells. Von Kossa stain showed small intracytoplasmic basophilic granular inclusions, and these histiocyte cells showed numerous Michaelis-Gutmann bodies, findings considered as diagnostic features of colonic malakoplakia. This is a rare case of isolated malakoplakia of the transverse colon diagnosed on endoscopic specimens. The majority of reported cases have shown an association between systemic diseases and colorectal adenocarcinoma. In addition, most reported cases of colonic involvement have been in the rectum, sigmoid, and right colon.
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Affiliation(s)
- Rawad A. Yared
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Hussein A. Badran
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Mohammed Hussein Kamareddine
- Saint George Hospital University Medical Center, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Youssef Ghosn
- Saint George Hospital University Medical Center, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Roula Bou Khalil
- Department of Endocrinology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Khaled El Ajamy
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Camil Chouairy
- Department of Pathology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Said G. Farhat
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
- *Assist. Prof. Said G. Farhat, MD, Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, PO Box 166378, Achrafieh, Beirut (Lebanon), E-Mail
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8
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Histiocytic disorders of the gastrointestinal tract. Hum Pathol 2013; 44:683-96. [DOI: 10.1016/j.humpath.2012.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 05/12/2012] [Accepted: 05/16/2012] [Indexed: 12/27/2022]
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Abstract
Colonic pseudolipomatosis is rare and its pathogenesis is still unclear. A number of mechanisms, including mechanical injury during an endoscopic procedure or chemical injury by disinfectant, seem to contribute to its pathogenesis. In our endoscopy unit, pseudolipomatosis occurred in an epidemic pattern after changing the endoscopic disinfectant from 2% glutaraldehyde to peracetic acid compound to decrease the length of endoscope reprocessing time. We assumed that pseudolipomatosis could be a type of chemical colitis produced by the residual disinfectant solution that remained on the surface or in a channel of the endoscope after reprocessing. The aim of this report was to highlight a series of 12 cases of colonic pseudolipomatosis in order to describe the endoscopic and pathological features and discuss the harmful effect of disinfectants as a possible cause of pseudolipomatosis. To identify the cause of the lesions, we systematically reviewed each patient history and the endoscopic and histological features. From March 2004 to February 2005, 1276 colonoscopies were performed and 12 cases (0.94%) of colonic pseudolipomatosis were diagnosed at the Kangnam Sacred Heart Hospital of Hallym University. The pathogenesis of colonic pseudolipomatosis is not well-known, but our experience indicates the endoscopic disinfectant as the probable cause of pseudolipomatosis rather than either mechanical traumatic injury or intraluminal air pressure-related injury.
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Lheureux S, Elie H, Michels JJ. [Malakoplakia associated with a colonic adenocarcinoma]. Ann Pathol 2012; 32:308-10. [PMID: 23010411 DOI: 10.1016/j.annpat.2012.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 07/04/2012] [Accepted: 07/05/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Stéphanie Lheureux
- Service d'oncologie médicale, centre François-Baclesse, avenue du-Général-Harris, 14000 Caen, France.
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Sekaran A, Dubale N, Lakhtakia S, Raju B, Ramchandani M, Darisetty S, Reddy DB, Reddy DN. Malakoplakia: an unusual cause of lower GI bleeding in a child. Gastrointest Endosc 2011; 74:443-5. [PMID: 21288516 DOI: 10.1016/j.gie.2010.11.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 11/19/2010] [Indexed: 02/08/2023]
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Bouguila J, Brahim K, Mokni M, Skandrani K, Harbi A, Essoussi AS, Boughammoura L. Digestive malacoplakia in children: case report. ISRN GASTROENTEROLOGY 2010; 2011:597350. [PMID: 21991519 PMCID: PMC3168563 DOI: 10.5402/2011/597350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 12/15/2010] [Indexed: 11/23/2022]
Abstract
Malacoplakia is a form of chronic granulomatous inflammatory reaction that rarely affects the pediatric age group. The gastrointestinal system is the second most common site for the occurrence of malacoplakia. We report the case of a 9-year-old girl who was hospitalized for abdominal pain, chronic diarrhea, and rectal hemorrhage. The endoscopic examinations and histopathology confirmed the diagnosis of intestinal malacoplakia. We successfully treated her with oral levofloxacin. This disease does not have any specific clinical or biological signs, and the diagnosis is exclusively based on histology.
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Affiliation(s)
- J. Bouguila
- Paediatrics Department, Hospital Farhat Hached, 4000 Ibn El Jazzar Street, Sousse, Tunisia
| | - K. Brahim
- Paediatrics Department, Hospital Farhat Hached, 4000 Ibn El Jazzar Street, Sousse, Tunisia
| | - M. Mokni
- Laboratory of Anathomopathology, Hospital Farhat Hached, Sousse, Tunisia
| | - K. Skandrani
- Cabinet Gastroenterology, Street Léopold Senghor, Sousse, Tunisia
| | - A. Harbi
- Paediatrics Department, Hospital Sahloul, Sousse, Tunisia
| | - A. S. Essoussi
- Paediatrics Department, Hospital Farhat Hached, 4000 Ibn El Jazzar Street, Sousse, Tunisia
| | - L. Boughammoura
- Paediatrics Department, Hospital Farhat Hached, 4000 Ibn El Jazzar Street, Sousse, Tunisia
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Krauel L, García-Aparicio L, Pérez N, Laguna A, Camacho A, Vilar P, Rodó J, Ribó JM. Urinary and gastrointestinal malakoplakia in a 12-year-old girl. Urology 2008; 73:87-9. [PMID: 18952264 DOI: 10.1016/j.urology.2008.05.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Revised: 04/15/2008] [Accepted: 05/15/2008] [Indexed: 11/30/2022]
Abstract
Malakoplakia is a rare chronic inflammatory disease that was originally described in the urinary bladder but can involve many other organs and soft tissues. It is believed to be caused by an alteration in the bacterial phagocytic system. Clinically, it is described as single or multiple tumors that can appear in any part of the body. Histologically, the presence of Michaelis-Gutmann bodies is pathognomonic. Malakoplakia in children is rare. Few pediatric cases in the urinary tract, kidney, or gastrointestinal tract have been published. We present a case of urinary and gastrointestinal malakoplakia in a 12-year-old girl.
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Affiliation(s)
- Lucas Krauel
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
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15
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Brevet M, Chatelain D, Bartoli E, Geslin G, Delcenserie R, Braillon A, Sevestre H, Dupas JL. Colonic pseudolipomatosis: clinical, endoscopical and pathological features in nine cases. ACTA ACUST UNITED AC 2006; 30:9-13. [PMID: 16514376 DOI: 10.1016/s0399-8320(06)73071-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED Colonic pseudolipomatosis is a rare and benign condition. It is not well known by gastroenterologists and its pathogenesis is still unclear. METHODS All cases of colonic pseudolipomatosis seen between February 2002 and June 2004 at the Amiens Universisty Hospital were identified and analyzed. RESULTS During this period, 2099 colonoscopies were performed and 9 cases of colonic pseudolipomatosis were diagnosed (0.4%). Patients were all males aged from 41 to 67 (median age 52 years). They consulted for rectal bleeding (two patients), diarrhea (two patients) or abdominal pain (two patients). In three patients, colonic pseudolipomatosis was a fortuitous discovery during colonoscopy for polyp surveillance. The lesions presented as whitish and yellowish slightly elevated plaques ranging in size from a few millimeters to 4 cm. They extended over a two to 20 cm-long area, located in the right (two patients), transverse (four patients) or left colon (three patients). Microscopic examination showed empty spaces in the lamina propria measuring from 50 to 600 microm. They were negative for anti-CD31, CD34 and PS100 antibodies at immunohistochemistry and negative for Sudan black in three cases. The ultrastructural study showed in two cases round spaces containing small fibrillary protein-like deposits that might be lymph. CONCLUSION Colonic pseudolipomatosis is rare. Its pathogenesis is not well-known but could be due to gas invasion or extravasation of lymph into lamina propria, maybe induced by mucosal lesions related to barotrauma or certain colonoscope cleaning solutions.
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Nakasono M, Hirokawa M, Muguruma N, Okahisa T, Okamura S, Ito S, Miyamoto H, Wada S, Fukuda T, Sano T. Colorectal xanthomas with polypoid lesion: report of 25 cases. APMIS 2004; 112:3-10. [PMID: 14961968 DOI: 10.1111/j.1600-0463.2004.apm1120102.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Little attention has been paid to colorectal xanthoma. To clarify the clinical and pathological features of colorectal xanthoma, we report 28 colorectal xanthomas biopsied from 25 patients. All were composed of typical xanthoma cells and showed polypoid configuration. Median age of the patients was 64 years and there were 15 men and 10 women. Diabetes mellitus, constipation, and hyperlipidemia were found in two, one, and seven patients, respectively. Seventeen (60.7%) of the 28 polyps were located in the sigmoid colon and the remaining 11 in the rectum. Twenty-three polyps (82.1%) were sessile. Twelve (60.0%) of twenty polyps that were recorded were reddish in color. Only two polyps revealed a yellowish tone. Microscopically, foamy cells were present in the lamina propria, but the submucosa did not contain foamy cells. Immunohistochemically, the foamy cells invariably expressed extensive positivity for CD68. The colonic glands showed a deformity in the case with moderate to intense density of the foamy cells. The surface epithelium showed a hyperplastic change in 22 (78.6%) xanthomas. The colonic glands in four xanthomas were also associated with hyperplastic changes. The basement membrane of the surface epithelium was often thickened. Cell debris and proliferation of the capillaries were observed just below the surface epithelium in 19 (67.9%) and 22 (78.6%) xanthomas, respectively. Previous mucosal minute injury was suggested as the pathogenesis of colorectal xanthomas. Colorectal xanthomas were not identical to gastric and esophageal xanthoma, endoscopically or microscopically. We prefer the term "xanthomatous polyp" rather than xanthoma in the colorectal region. They may be regarded as a novel type of colorectal non-neoplastic polyp.
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Affiliation(s)
- Masahiko Nakasono
- Department of Pathology, University of Tokushima School of Medicine, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
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Berney T, Chautems R, Berney T, Chautems R, Ciccarelli O, Squifflet JR, Latinne D, Pirson Y. Malakoplakia of the caecum in a kidney-transplant recipient: presentation as acute tumoral perforation and fatal outcome. Transpl Int 1999. [DOI: 10.1111/j.1432-2277.1999.tb01218.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Aun JJF, Oliveira MBBD, Aun MMF. Malacoplaquia intestinal. Rev Col Bras Cir 1998. [DOI: 10.1590/s0100-69911998000200018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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