Filiform polyposis in a 20-year-old patient with ulcerative colitis – a rare occurrence

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
R Ramanarasimhaiah ◽  
B Chae ◽  
M Toprak ◽  
L M Opitz ◽  
H Wu
Keyword(s):  
Ulcerative Colitis ◽  
Surgical Margin ◽  
Inflammatory Cells ◽  
Clinical History ◽  
Right Colon ◽  
Microscopic Evaluation ◽  
Bowel Diseases ◽  
History Of ◽  
Filiform Polyposis ◽  
The Right

Abstract Introduction/Objective Filiform polyposis (FP), also referred as inflammatory polyposis or pseudopolyposis, is an uncommon benign entity usually diagnosed in patients with history of Crohn’s disease, ulcerative colitis, interstitial tuberculosis or histiocytosis X. It is characterized by multiple finger-like mucosal projections/pseudopolyps seen more commonly in transverse and descending colon. Pathogenesis of FP is uncertain but it is hypothesized to be reactive process to chronic inflammation leading to formation of fingerlike projections. The term filiform polyposis was coined in 1974 by Appleman HD and his collegues to describe numerous long slender worm-like (filiform) colonic lesions seen in radiographs. Herein, we are going to present a case of FP diagnosed in a 20-year-old male with history of medically refractive ulcerative colitis. Methods/Case Report The patient is a 20-year-old male, with a history of medically refractive ulcerative colitis on systemic steroids and vedolizumab. He underwent sigmoidoscopy and colonoscopy which reveals multiple pedunculated, polypoid lesions, ranging from 0.5 to 3 cm in length with white tips (cap of purulent mucous). Patient underwent total abdominal colectomy with end ileostomy. The specimen received by our deparment consist of a segment of right colon (63 cm in length, 3.5 cm in diameter) with attached ileum (3 cm in length, 2 cm in diameter) and appendix (6 cm in length, 0.8 cm in diameter). The part of the right colon is constricted/strictured measuring 24 cm in length, 2 cm in diameter. Opening reveals numerous (>100) pedunculated, finger-like polypoid lesions measuring from 0.3 cm to 2 cm in length. The lesions involve the entire right colon including distal colonic surgical margin. Appendix and ileum are not involved by the lesion and grossly unremarkable. Microscopic evaluation of the lesions reveal acute and chronic inflammatory cells, granulation tissue, areas of necrosis and reactive changes with focal mucosal atrophy consistent with chronic ulcerative colitis. Results (if a Case Study enter NA) NA Conclusion Filiform polyposis (FP) is an uncommon benign entity commonly seen in association with Inflammatory Bowel Diseases. Diagnosing FP requires comprehensive gross and microscopic examination as well as review of clinical history and imaginig studies. Because of its uncommon nature, we recommend to report this entity to raise awareness and to educate the pathologists who have not diagnosed it before.

scholarly journals Articular manifestations in patients with inflammatory bowel disease treated with vedolizumab

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3275-3283 ◽  
Author(s):  
Anastasia Dupré ◽  
Michael Collins ◽  
Gaétane Nocturne ◽  
Franck Carbonnel ◽  
Xavier Mariette ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Bowel Diseases ◽  
History Of ◽  
Musculoskeletal Manifestations ◽  
Inflammatory Bowel

Abstract Objective Vedolizumab (VDZ) has been incriminated in the occurrence of articular manifestations in patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe musculoskeletal manifestations occurring in IBD patients treated by VDZ and to identify risk factors. Methods In this retrospective monocentric study, we included all consecutive patients treated by VDZ for IBD in our hospital. Incident musculoskeletal manifestations occurring during VDZ treatment were analysed and characteristics of patients with and without articular inflammatory manifestations were compared. Results Between 2013 and 2017, 112 patients were treated with VDZ for IBD: ulcerative colitis (n = 59), Crohn’s disease (n = 49) and undetermined colitis (n = 4). Four patients (3.6%) had a history of SpA, whereas 13 (11.6%) had a history of peripheral arthralgia. Some 102 (91.1%) patients had previously received anti-TNF. After a mean (S.d.) follow-up of 11.4 (8.6) months, 32 (28.6%) patients presented 35 musculoskeletal manifestations, of which 18 were mechanical and 17 inflammatory. Among the latter, 11 had axial or peripheral SpA, 5 had early reversible arthralgia and 1 had chondrocalcinosis (n = 1). Among the 11 SpA patients, only 3 (2.6%) had inactive IBD and may be considered as paradoxical SpA. The only factor associated with occurrence of inflammatory manifestations was history of inflammatory articular manifestation [7/16 (43.8%) vs 10/80 (12.5%), P = 0.007]. Conclusion Musculoskeletal manifestations occurred in almost 30% of IBD patients treated with VDZ, but only half of them were inflammatory. Since most of the patients previously received anti-TNF, occurrence of inflammatory articular manifestations might rather be linked to anti-TNF discontinuation than to VDZ itself.

scholarly journals Distonía Periférica Post-Traumática. Reporte De Un Caso.

2019 ◽  
Vol 38 (2) ◽  
Author(s):  
Ana Raquel Goti Polanco ◽  
Fernando Gracia
Keyword(s):  
Spontaneous Recovery ◽  
Clinical History ◽  
Cervical Region ◽  
Multiple Drug ◽  
Number Of Patients ◽  
History Of ◽  
Post Traumatic ◽  
The Right ◽  
Plexus Block ◽  
Possible Cause

<p><strong>[Post-Traumatic Peripheral Dystonia. Report Of A Case]</strong></p><div><br />Resumen<br />Introducción: La distonía es un trastorno del movimiento caracterizado por contracciones musculares relativamente sostenidas que producen posturas anormales y repetitivas. Un pequeño número de pacientes con distonía representan los traumas como posible causa. Caso Clínico: Paciente femenina de 15 años de edad con historia de trauma con objeto contuso en región cervical con pérdida de conocimiento y recuperación espontánea. Inmediatamente refirió dolor cervical posterior. Dos días después, presentó movimientos distónicos en miembro superior derecho (MSD) y se agregaron mioclonías, por lo que se hospitalizó. Se manejó con múltiples esquemas de medicamentos, sin mejoría. Se realizó bloqueo de plexo braquial derecho con mejoría de la sintomatología. Conclusión: Los casos de distonía post-traumática son poco comunes. Se debe considerar al momento de evaluar un traumatismo. La historia clínica es la herramienta más valiosa para llegar al diagnóstico, siempre descartando otras posibles causas.</div><div> </div><div> </div><div>Abstract<br />Introduction: Dystonia is a movement disorder characterized by relatively sustained muscle contractions that produce abnormal and repetitive postures. A small number of patients with dystonia represent traumas as a possible cause. Clinical Case: Female patient of 15 years of age with a history of trauma with blunt object in the cervical region with loss of consciousness and spontaneous recovery. Immediately he reported posterior cervical pain. Two days later, he presented dystonic movements in the right upper limb (MSD) and myoclonus was added, so he was hospitalized. It was managed with multiple drug schemes, without improvement. Right brachial plexus block was performed with improvement of the symptomatology. Conclusion: Cases of post-traumatic dystonia are uncommon. It should be considered when assessing a trauma. The clinical history is the most valuable tool to reach the diagnosis, always discarding other possible causes.</div>

scholarly journals Diabetic mastopathy: A clinical and radiological challenge

2010 ◽  
Vol 14 (4) ◽  
pp. 113
Author(s):  
Debra Ardath Meerkotter ◽  
Grace Rubin
Keyword(s):  
Inflammatory Cells ◽  
Breast Disease ◽  
Glandular Tissue ◽  
Cell Infiltrate ◽  
Recent Onset ◽  
Diabetic Mastopathy ◽  
History Of ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
The Right

A 41-year-old woman presented with a lump above the right areola. She also complained of a burning and heavy sensation of the right breast of recent onset. On further history, the patient was an insulin-dependent diabetic of 35 years’ duration. She had no family history of breast disease. On examination, a palpable thickening above the right areola was detected. Bilateral mammography revealed dense fibro-glandular tissue, denser in the right retro-areolar region than the left, with right peri-areolar skin thickening. There was no discreet mass nor suspicious microcalcifications or axillary adenopathy. Ultrasound (US) demonstrated an ill-defined peri-areolar region of decreased echogenicity and posterior shadowing. Core biopsy under US guidance showed abundant thick collagen bands containing epitheloid fibroblasts and a stroma with small capillary-sized and larger muscularised blood vessls, some of which contained peri-vascular lymphocytic inflammatory cells. Small ductal elements and an occasional lobule showed a peri-ductal and a peri- and intra-lobular lymhocytic and plasma cell infiltrate. These features were in keeping with sclerosing lymphocytic mastitis, known also as diabetic mastopathy.

scholarly journals The Coexistence of Colorectal Polyps in the Right Colon Increases the Malignant Risk of Laterally Spreading Tumors

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xiaonan Shen ◽  
Yao Zhang ◽  
Yunjia Zhao ◽  
Xiaobo Li ◽  
Zhizheng Ge ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Binary Logistic Regression ◽  
Colorectal Polyps ◽  
Right Colon ◽  
History Of ◽  
Predictors Of Outcomes ◽  
The Right ◽  
Laterally Spreading Tumors

Background. The coexistence of colorectal polyps with laterally spreading tumors (LSTs) is commonly observed during colonoscopy. However, there are rare studies that assess the malignant risks for LSTs with colorectal polyps, which might largely contribute to further strategies of treatment and follow-up plans in LSTs. Methods. We conducted a retrospective cohort study that enrolled 206 patients with LSTs in the Endoscopy Center and Endoscopy Research Institute, Renji Hospital, Shanghai Jiao Tong University, China. The subjects with LSTs were divided into two groups: the nonpolyp group with 89 patients and the polyp group with 117 patients. Binary logistic regression was used to identify the independent predictors of outcomes of interest. Results. The risk of the polyps’ coexistence phenomenon increased in males compared with females (OR=2.138, p=0.047), especially in those between 50 and 75 years old (OR=7.074, p=0.036). Tumor size (3–4 cm), LSTs with tubulovillous types, and history of polyps statistically increased the risk of the polyp coexistence phenomenon (OR=5.768, p=0.003; OR=36.345, p=0.024; OR=13.245, p<0.0001, respectively). LST-NG-PD (OR=20.982, p=0.017) and LSTs≥5 cm (OR=37.604, p=0.038) notably increased the malignant risk of LSTs. When the simultaneous polyps are located in the right colon, the risk of malignant LSTs (OR=58.540, p=0.013) positively increased. Conclusion. The simultaneous colorectal polyps in the right colon were the most important risk factor to predict the malignant risk of LSTs.

Abstract 1768: Magnetic Resonance Imaging Reveals Novel Phenotypic Expression of Desmosomal Mutation in First-Degree Relatives of Patients with Arrhythmogenic Right Ventricular Dysplasia (ARVD). Prevalence and Clinical Significance in Patients Evaluated For ARVD.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Harikrishna Tandri ◽  
Darshan Dalal ◽  
Aditya Jain ◽  
Daniel P Judge ◽  
Theodore Abraham ◽  
...  
Keyword(s):  
Family History ◽  
Right Ventricular ◽  
Phenotypic Expression ◽  
Clinical History ◽  
Arrhythmogenic Right Ventricular Dysplasia ◽  
First Degree Relatives ◽  
Group 4 ◽  
Right Ventricular Dysplasia ◽  
History Of ◽  
The Right

Background: In this report we present the prevalence and significance of a novel MRI abnormality that we identified in desmosomal mutation positive asymptomatic relatives of arrhythmogenic right ventricular dysplasia (ARVD) patients. Methods: MRI of 38 first-degree relatives was analyzed for abnormalities blinded to the mutation status. Focal crinkling of the right ventricle (accordion sign) was observed in 15/25 mutation positive vs. 0/13 mutation negative patients. The presence of this finding was sought in 207 patients evaluated for ARVD blinded to clinical history and was correlated with electrophysiologic findings. Results: Mean age of the population was 32±16, 61% had a family history of ARVD. Based on non-invasive testing the 207 patients were classified into 4 groups 1) 106 normal, 2) 57 Idiopathic ventricular tachycardia (VT), 3) 33 probable ARVD, 4) 11 definite ARVD. A family history of ARVD was present in 74%, 0%, 67% and 36% respectively. 43 patients had the “accordion sign” and the prevalence in the four groups was 10%, 5%, 70% and 100% respectively. The abnormality was seen in the sub-tricuspid region in 62%, outflow tract in 30% in both regions in 8%. After excluding group 4, 48% of patients with the accordion sign had T wave inversion’s beyond V1 compared with 7% of those without the sign (p<0.001). During electrophysiologic testing, reentrant VT could be induced in 44% (7/16) of patients with accordion sign compared to 2% (1/48) without the sign (p<0.01). Conclusion: Focal crinkling of the RV termed “Accordion sign” may represent an early manifestation of ARVD that correlates with mutation positive status and predicts inducibility of ventricular arrhythmias.

Peran Computed Tomography (CT) Toraks dalam Diagnosis Abses yang Menyerupai Massa Mediastinum

2016 ◽  
Vol 1 (3) ◽  
pp. 178-184
Author(s):  
Krishna P. Wicaksono ◽  
Aziza G. Icksan
Keyword(s):  
Clinical History ◽  
Chest Ct ◽  
X Ray ◽  
Precise Diagnosis ◽  
Life Threatening ◽  
History Of ◽  
Facial Edema ◽  
Chest X Ray ◽  
The Right ◽  
Peripheral Enhancement

Mediastnal abscess is rare, yet it could be a life threatening infecton. A precise diagnosis followed by adequate treatments need to be quickly established. Clinical informaton is usually not diagnostc. Therefore, radiological examinatons have important role.We report a ffy-one years old female with clinical history of sore throat, cough and neck-facial edema since fve days before admission. Laboratory examinatons revealed leukocytosis and ESR elevaton. Chest x-ray depicted a homogenous consolidaton in the right paratracheal region which deviated trachea to the lef. On enhanced chest CT examinaton, we found a cystc mass in the right paratracheal region, extending to the right supero-anterior mediastnum, with peripheral enhancement, air-?uid level and minimal right pleural e?usion, suggestve for mediastnal abscess. Bronchoscopy found no abnormality.Several days later, mediastnal abscess was confrmed surgically and drained through thoracotomy. Although culture of pus failed to grow any bacteria, histopathological examinaton confrmed a non-specifc chronic in?ammaton with no sign of malignancy. The main purpose of this report is to emphasize the importance of enhanced chest CT in evaluatng patent with tumor mimicking mediastnal abscess.

Efficacy of the drug containing sodium picosulfate and magnesium citrate in bowel preparation for colonoscopy in children

2020 ◽  
Vol 15 (4) ◽  
pp. 32-39
Author(s):  
T.N. Budkina ◽  
◽  
V.I. Oldakovskiy ◽  
A.V. Tupylenko ◽  
V.S. Tsvetkova ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Key Words Children ◽  
Control Group ◽  
Magnesium Citrate ◽  
Right Colon ◽  
Bowel Diseases ◽  
Sodium Picosulfate ◽  
Inflammatory Bowel ◽  
The Right

Objective. To evaluate the efficacy, safety, and tolerability of the drug containing sodium picosulfate and magnesium citrate (SPMC) used for bowel preparation in children. Patients and methods. We have assessed the quality of bowel preparation for colonoscopy in 80 children aged between 9 and 18 years (40 of them received SPMC for it and another 40 were prepared by cleansing enemas). The effectiveness of bowel preparation was evaluated using the Boston and Chicago Bowel Preparation Scales (BPS). Tolerability of the SPMC preparation scheme was estimated using a specially designed questionnaire. Results. Effective bowel preparation was achieved in 85% children receiving SPMC (excellent in 27.5% of cases and good in 57.5% of cases), whereas children in the control group have demonstrated significantly lower quality of bowel preparation (p = 0.021). We have observed that the right colon was significantly better prepared in the SPMC group than in the control group (p < 0.001). Ninety percent of children were satisfied with the SPMC preparation scheme and agreed to use it in the future. Conclusion. Preparation of children for colonoscopy with SPMC was effective, safe, and well tolerated by them; therefore, SPMC is preferable over traditional cleansing enemas. Key words: children, inflammatory bowel diseases, colonoscopy, bowel preparation, sodium picosulfate–magnesium citrate

Een zeldzame oorzaak van dementie: de bestralingsencephalopathie

2001 ◽  
Vol 13 (3) ◽  
pp. 76-78
Author(s):  
N. van de Weg ◽  
F.R.J. Verhey ◽  
P J.M. Raedts ◽  
F W. Vreeling
Keyword(s):  
Cystic Lesion ◽  
Clinical History ◽  
Memory Deficits ◽  
Attention And Memory ◽  
Long Period ◽  
Personality Changes ◽  
History Of ◽  
Radiation Encephalopathy ◽  
The Right ◽  
The Brain

SUMMARYWe describe the clinical history of a 49-year old woman, who demonstrated progressive personality changes more than twenty years after radiation of a pituitary adenoma (prolactinoma), with apathy, loss of initiative, memory deficits, postural instability, dysarthria and faecal incontinence. Neuropsychological assessment showed impulsivity, loss of overview, desinhibition, fluctuating deficits of attention, and memory disturbances. MRI-scanning of the brain revealed a cystic lesion along the right ventricle. The clinical picture and the findings of the other investigations are typical for dementia due to radiation encephalopathy. Such a long period between radiation and cognitive deterioration is rare, although it has been described before.

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