scholarly journals Elastofibromatous Polyp of the Sigmoid Colon - A Case Report and Review of Gastrointestinal Elastofibromas

2003 ◽  
Vol 17 (4) ◽  
pp. 275-277 ◽  
Author(s):  
Z Vesoulis ◽  
Pars Ravichandran ◽  
Dimitri Agamanolis ◽  
Duane Roe
Keyword(s):  
Sigmoid Colon ◽  
Present Report ◽  
Amorphous Material ◽  
Polypoid Lesion ◽  
Vascular Wall ◽  
Unknown Etiology ◽  
Current Case ◽  
Distinctive Features ◽  
Elastic Stain ◽  
Beaded Appearance

Elastofibromatous change in the gastrointestinal tract is a rarely reported, usually polypoid lesion of unknown etiology with submucosal stromal change that may mimic amyloid deposition. The constituent amorphous material of the polyp stroma has distinctive features that permit an accurate assessment and diagnosis including: distribution of the material predominantly in the submucosa; distinctive fibrillar and granular appearance of the deposits; thick, irregular, haphazardly arranged bundles of elastic fibres positive for Verhoeff’s elastic stain; ultrastructural fibres with an electron dense curvilinear or beaded appearance; lack of amyloid type vascular wall deposits; and lack of amyloid congophilia or crystal violet metachromasia.The clinical, light microscopic, histochemical and ultrastructural characteristics of this deposited material are reviewed in detail in the present report of a patient who presented with an asymptomatic polypoid lesion of the sigmoid colon. Other reported cases are summarized, and their clinical and pathological features are compared with the current case.

scholarly journals Sinonasal Sarcoidosis: A Case Report

2016 ◽  
Vol 15 (4) ◽  
pp. 648-650
Author(s):  
Afroza Khanam ◽  
Gulshan Akhtar ◽  
Nabila Khanduker ◽  
Nurun Nahar Chowdhury ◽  
Mohammad Abdur Rahman ◽  
...  
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Medical Science ◽  
Neck Region ◽  
Pulmonary Involvement ◽  
Unknown Etiology ◽  
Nasal Discharge ◽  
Diagnostic Challenge ◽  
Current Case ◽  
Nasal Blockage

Sarcoidosis is a chronic granulomatous disease of unknown etiology which principally affects the lower respiratory tract & lungs. Sarcoidosis in the head & neck region is infrequent. Isolated sino nasal sarcoidosis without pulmonary involvement is rare.Case: An 18 years old male patient presented with the complaints of nasal blockage, purulent nasal discharge which was occasionally blood stained for 6 months, deformity of nose, swelling of face & lips for 4 months & watering of eyes for same duration. Endoscopy of nose revealed intra nasal mucosal thickening which was friable & bleeds on touch. The diagnosis of sino nasal sarcoidosis was made by histopathological examination of nasal biopsy specimen.Conclusion: Sino nasal sarcoidosis is a disease of diagnostic challenge to the clinician as its mimicking clinical features may be misleading & cause delay in definitive diagnosis. In the current case report, we presented a case of sino nasal sarcoidosis presenting as chronic rhino sinusitis.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.648-650

scholarly journals A Rare Case of Granular Cell Tumor of the Anal Region: Diagnostic Difficulty to Masses in the Anal Area

2014 ◽  
Vol 99 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Takaaki Fujii ◽  
Hiroki Morita ◽  
Satoru Yamaguchi ◽  
Soichi Tsutsumi ◽  
Takayuki Asao ◽  
...  
Keyword(s):  
Rare Case ◽  
Granular Cell Tumor ◽  
Polypoid Lesion ◽  
Granular Cell ◽  
Clinical Findings ◽  
Japanese Woman ◽  
Cell Tumor ◽  
The Body ◽  
Current Case ◽  
Anal Region

Abstract Granular cell tumor may be located anywhere in the body; however, the gastrointestinal tract is infrequently involved and anal granular cell tumors are extremely rare. We report herein a rare case of granular cell tumor in the anal region. In the current case, a 66-year-old Japanese woman was found to have a polypoid lesion in the anus with hemorrhoids. The mass detected as an anal polypoid lesion with ulceration was resected and diagnosed as granular cell tumor by histologic examination. Granular cell tumor of the anal region is rare, and benign perianal polypoid lesions are relatively uncommon clinical findings. They might present diagnostic challenges to surgeons and pathologists. Awareness of the differential diagnosis of granular cell tumor and careful microscopic examination might allow proper management and diagnosis.

Abnormal Expression of Type 1 Plasminogen Activator Inhibitor and Tissue Factor in Severe Preeclampsia

1998 ◽  
Vol 79 (03) ◽  
pp. 500-508 ◽  
Author(s):  
Juan Gilabert ◽  
Salvador Grancha ◽  
Koji Yamamoto ◽  
Terri Thinnes ◽  
Francisco España ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Tissue Factor ◽  
Plasminogen Activator ◽  
Present Report ◽  
Interleukin 1 ◽  
Plasminogen Activator Inhibitor ◽  
Unknown Etiology ◽  
Activator Inhibitor ◽  
Pai 1

SummaryPreeclampsia is a multisystemic obstetric disease of unknown etiology that is commonly associated with fibrin deposition, occlusive lesions in placental vasculature, and intrauterine fetal growth retardation. We previously reported that type 1 plasminogen activator inhibitor (PAI-1) levels are significantly increased in plasma and placenta from pregnant women with preeclampsia compared to normal pregnant women. In the present report we localize the expression of placental PAI-1 in greater detail and compare it with that of tissue factor (TF), a procoagulant molecule, and vitronectin (Vn), a PAI-1 cofactor. We also examine the expression of two cytokines, tumor necrosis factor α (TNFα) and interleukin-1 (IL-1), in order to begin to define the underlying mechanisms responsible for the elevated levels of PAI-1 and fibrin deposits observed in placenta from preeclampsia. We demonstrate a significant increase in PAI-1, TF and TNFα antigen and PAI-1 and TF mRNA in placentas from preeclamptic patients. PAI-1 mRNA was increased not only in syncytiotrophoblast and infarction areas, but also in fibroblasts and in some endothelial cells of fetal vessels in placentas from preeclamptic patients. However, there was no colocalization between PAI-1, TF, Vn and TNFα in placental villi. The elevated TNFα in the placenta may induce PAI-1 and TF, and thus promote the thrombotic alterations associated with preeclampsia.

scholarly journals Collagenofibrotic Glomerulonephropathy with Fibronectin Deposition in a Dog

2009 ◽  
Vol 46 (4) ◽  
pp. 688-692 ◽  
Author(s):  
J. Kamiie ◽  
K. Yasuno ◽  
K. Ogihara ◽  
A. Nakamura ◽  
S. Tamahara ◽  
...  
Keyword(s):  
Amorphous Material ◽  
Periodic Acid ◽  
Capillary Endothelium ◽  
Type Iii Collagen ◽  
Electron Microscopic ◽  
Periodic Acid Schiff ◽  
Current Case ◽  
Type Iii ◽  
Deep Blue ◽  
Fibronectin Deposition

We report herein a case of collagenofibrotic glomerulonephropathy in a 3-year-old Shiba Inu with severe proteinuria. Histologically, renal glomeruli were enlarged with massive deposition of a homogeneous eosinophilic substance within the mesangium and capillary walls. The deposits reacted weakly with periodic acid-Schiff, stained deep blue with Masson's trichrome, and were positive by immunofluorescence for type III collagen and fibronectin. Ultrastructurally, the deposits consisted of fibrils and amorphous material in the mesangial matrix and beneath the glomerular capillary endothelium. The fibrils had transverse bands analogous to those of collagen fibrils. Electron microscopy also revealed focal detachment of podocytes and foot process effacement in glomerular tufts, which suggested that podocyte injury had contributed to the development of proteinuria in this dog. The current case resembles collagenofibrotic glomerulonephropathy (CFGN) in humans in histopathologic, immunofluorescence, and electron microscopic findings. This is the first report of CFGN in a nonhuman species with glomerular deposition of fibronectin and type III collagen.

scholarly journals Look Out before Polypectomy in Patients with Diverticular Disease – A Case of a Large, Inverted Diverticulum of the Colon Resembling a Pedunculated Polyp

2010 ◽  
Vol 24 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Omero Alessandro Paoluzi ◽  
Claudio Tosti ◽  
Fabio Andrei ◽  
Italo Stroppa ◽  
Francesco Pallone
Keyword(s):  
Diverticular Disease ◽  
Present Report ◽  
Polypoid Lesion ◽  
Screening Colonoscopy ◽  
Endoscopic Polypectomy ◽  
Colonic Diverticulum ◽  
Abdominal Symptoms ◽  
Pedunculated Polyp ◽  
Colonic Diverticula ◽  
Giant Colonic Diverticulum

Diverticular disease of the colon may be responsible for abdominal symptoms requiring colonoscopy, which may reveal the presence of concomitant polyps. A polyp found during colonoscopy in patients with colonic diverticular disease may be removed by endoscopic polypectomy with electrosurgical snare, a procedure associated with an incidence of perforation of less than 0.05%. The risk of such a complication may be higher in the event of an inverted colonic diverticulum, which may be misinterpreted as a polypoid lesion at colonoscopy. To date, fewer than 20 cases of inverted colonic diverticula, diagnosed at colonoscopy or following air contrast barium enema, have been reported in the literature. The present report describes a 68-year-old woman who underwent a screening colonoscopy, which revealed a voluminous pedunculated polyp that was recognized to be an inverted giant colonic diverticulum before endoscopic polypectomy.

scholarly journals Granulomatous colitis in a patient with metastatic melanoma under immunotherapy: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stratigoula Sakellariou ◽  
Dionysia N. Zouki ◽  
Dimitrios C. Ziogas ◽  
Despoina Pouloudi ◽  
Helen Gogas ◽  
...  
Keyword(s):  
Literature Review ◽  
Adverse Events ◽  
Metastatic Melanoma ◽  
Sigmoid Colon ◽  
Checkpoint Inhibitors ◽  
Present Report ◽  
Disease Recurrence ◽  
Histological Evaluation ◽  
Granulomatous Colitis ◽  
Mucosal Edema

Abstract Background Immune checkpoint inhibitors (ICPIs) have changed the way advanced malignancies are currently confronted, improving cancer patients’ outcomes but also generating distinct immune-related (ir) adverse events. ICPIs-induced colitis is a common complication showing different clinical and histological manifestations. In the literature review, 14 cases with ICPIs related colon granulomas have been reported in 5 studies with either limited or unavailable information regarding histology. Granulomatous reactions can be mistakenly perceived as disease recurrence or progression. Better understanding and identification of this infrequent histological display can help to avoid misdiagnosis and mismanagement. Case presentation A 63-year-old female patient with metastatic melanoma was admitted to the hospital with symptoms of nausea, persistent diarrhea and shivering fever under consecutive treatments with ICPIs, initially pembrolizumab and subsequently ipilimumab. Sigmoidoscopy was performed revealing mucosal edema, hyperemia and erosions of the rectum and sigmoid colon. Histological evaluation of sigmoid colon mucosa biopsies revealed an unusual colitis pattern characterized by multiple intracryptal granulomas attributed to ICPIs therapy. Steroids were administered and the patient recovered. ICPIs treatment was discontinued. The patient was subsequently treated with chemotherapy but follow up radiology showed disease progression. A re-challenge with another ICPI regimen was decided and the patient is currently under immunotherapy with stable disease regarding melanoma status and without any sign of colitis recurrence. Conclusions The present report provides detailed histological description of a distinctive ICPIs-induced granulomatous colitis and highlights the need for awareness of the distinct adverse events and reaction patterns in the context of immunotherapy.

scholarly journals ACUTE INTESTINAL DIARRHEA INFECTION AS A TRIGGER OF ACUTE DIVERTICULITIS OF THE SIGMOID COLON

2018 ◽  
Vol 23 (3) ◽  
pp. 134-137
Author(s):  
Valery A. Malov ◽  
N. A. Tsvetkova ◽  
S. A. Isaenko ◽  
S. N. Triyniakov ◽  
A. N. Gorobchenko ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Sigmoid Colon ◽  
Large Intestine ◽  
Clinical Observation ◽  
Acute Diverticulitis ◽  
Unknown Etiology ◽  
Synovial Cysts

The clinical observation of the development of acute diverticulitis of the sigmoid colon following a previous acute intestinal diarrhea infection of unknown etiology by a gastroenteric variant is considered. Brief characteristics of the course of the diverticular disease of the colon are given. The possible interrelation of the diverticular disease of the large intestine with synovial cysts is considered.

scholarly journals A Rare Case of Gallstone Ileus: Bouveret Syndrome Presenting with Concurrent Gallstone Coleus

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sena Park ◽  
Janaka Balasooriya ◽  
Thembi Ncube
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Gallstone Ileus ◽  
Outlet Obstruction ◽  
Clinical History ◽  
Distal Colon ◽  
Postoperative Recovery ◽  
Current Case ◽  
Her Family ◽  
Bouveret Syndrome

Background. Bouveret syndrome and gallstone coleus are two rare subsets of gallstone ileus. Bouveret syndrome involves a gastric outlet obstruction, whereas gallstone coleus involves an obstruction of the large intestine. Both of the conditions are caused by gallstones, which migrated from the gallbladder via the fistulae. Due to its rarity, only few cases were reported for each condition. The current case describes an even rarer case of Bouveret syndrome and gallstone coleus presenting together. The case report will hopefully provide better understanding of the disease presentation and hence, lead to early diagnosis and management. Case. Ms. B is an 86-year-old woman of Italian background who presented to our emergency department with worsening symptoms of bowel obstruction. Her past clinical history included Kaposi sarcoma, hypertension, osteoarthritis, and vitamin D deficiency with surgical history including caesarean section and tonsillectomy. On her imaging, she had two large gallstones, one in the proximal duodenum and one in the distal colon. It also showed gastric dilatation and gas in the gall bladder. She was subsequently diagnosed with Bouveret syndrome with concurrent gallstone coleus. The laparotomy revealed two points of gallstone obstruction at the first part of the duodenum and at the distal sigmoid colon. Her postoperative recovery was uncomplicated. She was discharged to the care of her family and followed up in the general surgery clinic. Conclusion. The current case report describes a unique presentation of Bouveret syndrome where an additional gallstone was found simultaneously in the sigmoid colon causing the obstruction. By introducing this novel case of having two different subsets of gallstone ileus simultaneously, there will be a better understanding of both conditions and hopefully improve our scope of practice.

scholarly journals Gestational gigantomastia

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Letícia Augusto Garcia
Keyword(s):  
Reduction Mammaplasty ◽  
Rare Complication ◽  
Rare Condition ◽  
Fold Increase ◽  
Total Weight ◽  
Southeastern Brazil ◽  
Bilateral Mastectomy ◽  
Unknown Etiology ◽  
Current Case ◽  
Normal Delivery

Introduction: Gigantomastia is a disease of unknown etiology, which can occur in two different situations: gestational and non-gestational phases. The gestational type is a rare complication that affects 1:28,000 to 1:100,000 pregnancies and is usually bilateral. It consists of a diffuse, massive breast increase during pregnancy. In a normal pregnancy, the breasts double in size without sequelae; however, in this disease, the breast tissue may experience a 10 to 20-fold increase. The treatment varies from drug therapy to plastic surgery (mammaplasty) and radical surgery (mastectomy). Objectives: To report a case of gestational gigantomastia, its treatment approach, and outcome. Methods: Data from this study were obtained from a multidisciplinary clinical experience, image records, and literature search. Case Report: An 18-year-old patient, admitted to the mastology department of Hospital Guilherme Álvaro, in Santos, Southeastern Brazil, was diagnosed with gigantomastia in her 23rd week of pregnancy. The exacerbated breast growth during the gestational period caused pain and functional impairment to the patient. Bilateral mastectomy was performed at 27 weeks of pregnancy due to the worsening of her pulmonary condition, leading to the risk of maternal and fetal death. Macroscopic anatomopathological examination revealed breasts with a total weight of 27 kg, lobular hyperplasia, pronounced stromal hyperplasia, and necrosis of the breast parenchyma. She stayed in the intensive care unit during the postoperative period with good progression. The patient had a normal delivery at 38 weeks of gestation with a live fetus. Discussion: The ideal management for gestational gigantomastia is not clear. The treatment includes surgeries (reduction mammaplasty and total mastectomy with or without reconstruction), medications, or a combination of both. In the current case, the treatment chosen was mastectomy during pregnancy due to respiratory distress and the risk of sepsis by ischemic tissue necrosis. During the surgical procedure, there was a risk of hemodynamic instability, given the large volume of breast removed, representing 40% of the total weight of the patient. Conclusion: Gestational gigantomastia is an exceptionally rare condition, and the literature has few reports on the subject. The therapeutic management depends on factors intrinsic to the patient, so each case requires individualization. The therapeutic decision aims at the best prognosis, taking into account possible complications and a reduction in maternal and fetal morbidity.

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