Filiform polyposis with sigmoid colon adenocarcinoma: a case report

Abstract Background Filiform polyposis is a rare form of inflammatory polyposis, which is occasionally formed in the colon of patients with history of inflammatory bowel disease (IBD). It is characterized by presence of several to hundreds of slender, worm-like polyps in the colon lined by histologically normal colonic mucosa and often coalesce, resulting in a tumor-like mass. Filiform polyposis is most frequently associated with a post-inflammatory reparative process in patients with IBD history, and only cases of filiform polyposis occurring in patients without IBD history have been reported. Filiform polyposis has been considered as a benign inflammatory polyposis without any risk of dysplasia, while the possibility of carcinogenesis of inflammatory polyps is not fully excluded. To date, only three cases of filiform polyposis coexisting with dysplasia have been reported. Case presentation A 59-year-old male patient with no past medical history of IBD underwent laparoscopic sigmoidectomy for obstructive filiform polyposis, which was associated with sigmoid colon adenocarcinoma. Based on the histological findings of the resected specimen, invasive sigmoid colon adenocarcinoma was surrounded by filiform polyposis, and adenocarcinoma also scattered uniformly on the surface of filiform polyposis. In immunohistochemistry, abnormal p53 expression was observed in adenocarcinoma, while it was not shown in mucosa on filiform polyposis. Conclusions This is the fourth case of filiform polyposis that is closely associated with colon dysplasia or adenocarcinoma based on histological findings. However, immunohistochemical findings did not support the theory that inflammation initiates adenocarcinoma in filiform polyposis like IBD. Hence, further immunohistochemical and genetic analyses are needed to clarify the association between filiform polyposis and carcinogenesis.

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An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

10.31487/j.gscr.2020.01.03 ◽

2020 ◽

pp. 1-5

Author(s):

Anton Stift ◽

Kerstin Wimmer ◽

Felix Harpain ◽

Katharina Wöran ◽

Thomas Mang ◽

...

Keyword(s):

Case Report ◽

Sigmoid Colon ◽

Immunohistochemical Staining ◽

Late Onset ◽

Hirschsprung Disease ◽

Endoscopic Examination ◽

Case Presentation ◽

Idiopathic Megacolon ◽

History Of ◽

Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

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Asymptomatic Eosinophilic Infiltration with Endoscopic and Histological Findings Consistent with Eosinophilic Gastritis

Case Reports in Gastroenterology ◽

10.1159/000516688 ◽

2021 ◽

pp. 652-656

Author(s):

Kazuki Yamamoto ◽

Takeshi Okamoto ◽

Katsuyuki Fukuda

Keyword(s):

Asymptomatic Patient ◽

Gastrointestinal Symptoms ◽

The Body ◽

Eosinophilic Infiltration ◽

Histological Findings ◽

High Power Field ◽

Medical Checkup ◽

Endoscopic Findings ◽

Eosinophilic Gastritis ◽

History Of

Eosinophilic gastritis often presents with gastrointestinal symptoms in the absence of abnormal endoscopic findings. On the other hand, endoscopic changes due to eosinophilic infiltration in an asymptomatic patient are rare. A 29-year-old woman with a history of asthma on steroid inhalers presented for an annual medical checkup. Esophagogastroduodenoscopy revealed diffuse white granular patches in the body of the stomach, suggestive of eosinophilic gastritis. Histology showed over 100 eosinophils per high-power field, also consistent with eosinophilic gastritis. As the absence of symptoms precluded the diagnosis of eosinophilic gastritis, the patient was diagnosed with asymptomatic eosinophilic infiltration of the stomach.

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Cervical thymoma

Sao Paulo Medical Journal ◽

10.1590/s1516-31801999000300008 ◽

1999 ◽

Vol 117 (3) ◽

pp. 132-135 ◽

Cited By ~ 4

Author(s):

Abrão Rapoport ◽

Claudiane Ferreira Dias ◽

João Paulo Aché de Freitas ◽

Ricardo Pires de Souza

Keyword(s):

Case Report ◽

Thyroid Gland ◽

Rare Disease ◽

Female Patient ◽

Thallium 201 ◽

Accurate Diagnosis ◽

Nuclear Resonance ◽

Histological Findings ◽

History Of ◽

Iodine 131

CONTEXT: Cervical thymoma is a primitive thymic neoplasia. It is very rare. This disease presents higher incidence in female patients in their 4th to 6th decade of life. We present a case report of a cervical thymoma CASE REPORT: 54-year-old female patient, caucasian, with no history of morbidity, presenting a left cervical nodule close to the thyroid gland. During the 30 months of investigation a left cervical nodule grew progressively next to the thyroid while the patient showed no symptoms, making accurate diagnosis difficult. Tests on her thyroid function did not show changes, nor were there changes in any subsidiary tests. The diagnosis of the disease was made intra-operatively through total thyroid individualization. The results were confirmed by the histological findings from the ressected material. Cervical thymoma is a very rare disease, with difficult preoperatory diagnosis. Some additional study methods which are employed today are thallium 201, technetium 99 and iodine 131 scintigraphy, magnetic nuclear resonance and especially histopathological findings and classification.

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

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqab191.123 ◽

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.

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Desmoid tumor of the anterior abdominal wall in a female (Clinical case)

HEALTH OF WOMAN ◽

10.15574/hw.2018.131.116 ◽

2018 ◽

pp. 116-118

Author(s):

M.V. Makarenko ◽

◽

D.O. Govseyev ◽

S.V. Gridchin ◽

N.H. Isaeva ◽

...

Keyword(s):

Abdominal Wall ◽

Desmoid Tumor ◽

Clinical Case ◽

Anterior Abdominal Wall ◽

Correct Diagnosis ◽

Final Diagnosis ◽

Histological Findings ◽

History Of ◽

Slow Growing ◽

Wall Tumor

Desmoid tumors (also called desmoids fibromatosis) are rare slow growing benign and musculoaponeurotic tumors. Although these tumors have a propensity to invade surrounding tissues, they are not malignant. These tumors are associated with women of fertile age, especially during and after pregnancy and postoperative surgeries. Our clinical case is interesting because of the rarity of the pathology and the difficulties in setting the correct diagnosis. The patient, with a history of laparoscopic myomectomy (2012), was preparing for a routine surgery for the endometrioma of the anterior abdominal wall, according to the results of the ultrasound and computed tomography. After surgical treatment, the final diagnosis was changed, based on the histological findings. Key words: desmoid tumor, abdominal wall tumor, fibroid.

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Diffuse Filiform Polyposis With Unique Histology Mimicking Familial Adenomatous Polyposis in a Patient Without Inflammatory Bowel Disease

Archives of Pathology & Laboratory Medicine ◽

10.5858/2007-131-1821-dfpwuh ◽

2007 ◽

Vol 131 (12) ◽

pp. 1821-1824

Author(s):

Gerard J. Oakley III ◽

Wolfgang H. Schraut ◽

Robert Peel ◽

Alyssa Krasinskas

Keyword(s):

Inflammatory Bowel Disease ◽

Small Bowel ◽

Familial Adenomatous Polyposis ◽

Bowel Disease ◽

Nerve Fibers ◽

Normal Colonic Mucosa ◽

Adenomatous Polyposis ◽

Inflammatory Bowel ◽

Filiform Polyposis ◽

Vascular Hamartoma

Abstract Filiform polyposis is an uncommon entity that is most often encountered in the colon of patients with a history of inflammatory bowel disease (IBD). Filiform polyposis is characterized by a large number of “wormlike” polyps lined by histologically normal colonic mucosa. These polyps can mimic adenomatous polyps. Only rare cases without a history or evidence of IBD have been reported. Neuromuscular and vascular hamartoma of the small bowel is a rare, focal disorder characterized by disorganized smooth muscle fascicles throughout the submucosa accompanied by fibrosis, nerve fibers, ganglion cells, and vessels. To our knowledge, there is only one report of this lesion in the large bowel (cecum), where it presented as a mass. Here we report the case of a 50-year-old man with no known history or symptoms of IBD presenting with filiform polyposis involving the entire colon, clinically mimicking familial adenomatous polyposis, and showing histologic features similar to neuromuscular and vascular hamartoma of the small bowel.

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Case 9.22

Mayo Clinic Body MRI Case Review ◽

10.1093/med/9780199915705.003.0244 ◽

2014 ◽

pp. 463-464

Author(s):

Christine U. Lee ◽

James F. Glockner

Keyword(s):

Sigmoid Colon ◽

Chronic Inflammation ◽

Pelvic Pain ◽

Crohn Disease ◽

Perianal Fistula ◽

Bloody Diarrhea ◽

Ileocecal Resection ◽

History Of ◽

Heterogeneous Enhancement

23-year-old man with a history of Crohn disease and previous ileocecal resection, now with abdominal pelvic pain, bloody diarrhea, and a suspected perianal fistula Axial postgadolinium 3D SPGR images (Figure 9.22.1) demonstrate moderate thickening of the sigmoid colon consistent with Crohn colitis and severe diffuse thickening and heterogeneous enhancement of the rectum. Note the prominent perirectal and right inguinal adenopathy, as well as perirectal fibrofatty proliferation that is likely secondary to chronic inflammation....

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Urachal Mucinous Cystic Tumor of Low Malignant Potential with Concurrent Sigmoid Colon Adenocarcinoma

Case Reports in Gastrointestinal Medicine ◽

10.1155/2019/1434838 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Kelly Brennan ◽

Paul Johnson ◽

Heather Curtis ◽

Thomas Arnason

Keyword(s):

Sigmoid Colon ◽

Incidental Finding ◽

Colon Adenocarcinoma ◽

Malignant Potential ◽

Cystic Tumor ◽

Mucinous Cystic Tumor ◽

Therapeutic Implications ◽

Diagnostic Pitfall ◽

Low Malignant Potential ◽

Peritoneal Spread

Urachal mucinous tumors are rare neoplasms with behaviour that can range from relatively benign to malignancy that can spread distantly or throughout the peritoneum as pseudomyxoma peritonei or peritoneal carcinomatosis. Here we describe a unique case of urachal mucinous cystic tumor of low malignant potential confined to an intact cyst at the dome of the urinary bladder, without rupture or peritoneal spread. The urachal mucinous tumor was an incidental finding on a staging CT scan performed for sigmoid colon adenocarcinoma. We believe that this case illustrates a potential diagnostic pitfall which could have prognostic and therapeutic implications. Due to the intestinal phenotype of these neoplasms, a urachal tumor of low malignant potential could be mistaken for metastatic spread from a colonic adenocarcinoma in the rare situation such as this case, where the two neoplasms occur concurrently.

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