1/207. Small bowel carcinoid presenting as a barolith.Baroliths are rare complications of barium contrast roentgenography that occur almost exclusively in the colon. Baroliths are often asymptomatic, but may be associated with abdominal pain, appendicitis, bowel obstruction, or perforation. We present an unusual case of a barolith which developed within the lumen of the small bowel, and resulted in the detection of an otherwise occult carcinoid tumor of the ileum.- - - - - - - - - - ranking = 1keywords = bowel (Clic here for more details about this article) |
2/207. A case of intra-abdominal multiple lymphangiomas in an adult in whom the immunological evaluation supported the diagnosis.A 60-year-old patient with intra-abdominal lymphangiomatosis is described. He presented with anaemia due to enteric haemorrhage, hypoproteinaemia with heavy hypogammaglobulinaemia and T-cell lymphopenia. Duodenal biopsy showed lymphangiectasia while a small bowel study revealed several filling defects in the terminal ileum. On exploratory laparotomy, numerous inoperable lymphangio-haemangiomata were found, involving the small and large intestine, appendix, mesenterium, gallbladder and main biliary tract. The importance of T-cell lymphopenia and hypogammaglobulinaemia in the diagnosis of intra-abdominal lymphangiomatosis with lymphangiectasia is stressed.- - - - - - - - - - ranking = 0.16666666666667keywords = bowel (Clic here for more details about this article) |
3/207. Coincidence of Crohn's disease and a high-risk gastrointestinal stromal tumor of the terminal ileum.A 51-year-old male patient presented with characteristic radiologic features of Crohn's disease in the terminal ileum plus a large tumorous lesion in the right lower abdomen. Because of rapid crescent symptoms of bowel obstruction, the patient underwent surgery revealing a high-risk gastrointestinal stromal tumor (GIST) of the terminal ileum within an area of Crohn's ileitis. Whereas the association of chronic inflammatory bowel disease (IBD) and gastrointestinal adenocarcinoma is well known, other primary intestinal tumors are rare in these patients, particularly at the time of onset of clinical symptoms. This is the 3rd patient reported in the literature with a sarcoma complicating IBD, and in fact, the first description of the coincidence of Crohn's disease and GIST. Though the present case is likely to be a mere coincidence of two pathologically distinct entities (without any potential causal relationship), it should remind one of the possibility of small bowel 'Crohn's carcinoma' in patients with a sudden change in symptomatology as well as in those in whom intestinal obstruction fails to resolve with adequate therapy.- - - - - - - - - - ranking = 0.93188762572161keywords = inflammatory bowel disease, bowel, inflammatory bowel, bowel disease (Clic here for more details about this article) |
4/207. Inflammatory myofibroblastic tumor with extensive involvement of the bowel in a 7-year-Old child.We present a case of unusual localization of inflammatory fibroblastic tumor in the terminal ileum, cecum, and ascending colon in a 7-year-old child. Segmental resection of the terminal ileum, cecum, and ascending colon with a tumor mass up to 6 cm in diameter was performed. Pathohistological examination of biopsy specimen was performed on routine hematoxylin-eosin sections, as well as immunohistochemically with primary antibodies to CD3, CD20, CD68, factor viii, vimentin, smooth muscle actin, desmin, cytokeratin and S-100 protein, and k and l light chains. The tumor was composed of highly vascularized tissue with interlacing fascicles of elongated spindle cells admixed with plasma cells, histiocytes, lymphocytes, and eosinophils. The diagnosis of inflammatory myofibroblastic tumor was confirmed by immunohistochemistry. Inflammatory myofibroblastic tumor cannot be distinguished clinically from highly malignant neoplasm or some other conditions. Surgical resection and careful pathohistological analysis are needed, and a long-term follow-up is recommended.- - - - - - - - - - ranking = 0.66666666666667keywords = bowel (Clic here for more details about this article) |
5/207. Plexiform neurofibroma of the small bowel infiltrated with metastatic adenocarcinoma.Neurofibromatosis Type 1 (NF1) is not classically associated with gastrointestinal manifestations although these patients are at increased risk of several GI complications. We describe the ultrasound, CT and barium findings in a patient with NF1 who had a huge benign plexiform neurofibroma of the ileum that was infiltrated with metastatic adenocarcinoma.- - - - - - - - - - ranking = 0.66666666666667keywords = bowel (Clic here for more details about this article) |
6/207. Epstein-Barr virus-positive primary gastrointestinal Hodgkin's disease: association with inflammatory bowel disease and immunosuppression.Inflammatory bowel disease (IBD) is associated with an increased risk of lymphoma, which is usually extraintestinal but sometimes may involve the diseased bowel itself. Most lymphomas described in this setting are of non-Hodgkin's type, but rare cases of Hodgkin's disease (HD) have been reported. We describe the clinicopathologic and molecular features of four patients with primary gastrointestinal HD. Three patients had preexistent Crohn's disease (CD), for which two of them had received immunosuppressive therapy. The fourth patient had a longstanding history of diverticulitis and myasthenia gravis and was receiving immunosuppressive therapy for the latter. Multifocal involvement of the bowel by HD was noted in all four cases. Disease was staged as IVA in one patient, IIIB in one patient, and IE in one patient, and the fourth patient died in the postoperative period before further workup. Two patients received chemotherapy, one of whom was dead at 9 months, whereas the other has no evidence of disease at 25 months' follow-up. The patient with IE disease did not receive any therapy because only a few microscopic foci of disease were present and is also without any evidence of disease at 17 months. The Reed-Sternberg (RS) cells in all four cases expressed CD30, CD15, EBER-1, and LMP-1; two of four were focally CD20-positive. VJ-polymerase chain reaction for immunoglobulin heavy chain (IgH) rearrangement showed a polyclonal pattern in all four cases. In two cases, laser capture microdissection was used to isolate individual RS and Hodgkin's cells, which contained rearranged immunoglobulin genes, confirming a B-cell genotype. Whereas one case showed a dominant clonal band present in all isolates, cells from the patient with stage IE disease clearly showed a polyclonal population of RS cells. Our findings indicate that HD arising in the setting of IBD or chronic inflammation is the result of an Epstein-Barr virus-driven lymphoproliferation, analogous to that found in other immunodeficient states. Disordered immunoregulation inherent to CD and immunosuppressive therapy for the latter may contribute to its development. The finding of polyclonal RS cells in a patient with early stage disease and apparent cure by surgical resection versus monoclonal RS cells in the patient with disseminated disease suggests that HD in the setting of immunodeficiency also may show molecular progression, in a manner similar to that occurring in conventional B-cell lymphoproliferative disorders arising in the same setting.- - - - - - - - - - ranking = 2.9549784738872keywords = inflammatory bowel disease, bowel, inflammatory bowel, bowel disease (Clic here for more details about this article) |
7/207. Small-bowel angiosarcoma after pelvic irradiation: a report of two cases.Angiosarcoma is a rare tumor in the small bowel. Several predisposing factors have been suggested, including external irradiation for another malignancy. Only six cases of small-bowel angiosarcoma in patients previously treated with pelvic irradiation for gynecological malignancies have been reported hitherto. We present here two patients in whom a diagnosis of small-bowel angiosarcoma was made 10 years or more after intrapelvic irradiation. These cases demonstrate poor prognosis in this disease. Although postirradiation angiosarcoma is a rare condition, its possibility should be kept in mind when operating on previously irradiated patients.- - - - - - - - - - ranking = 1.1666666666667keywords = bowel (Clic here for more details about this article) |
8/207. Carcinoid-related angiomatous polyposis simulating crohn disease.Polyposis associated with ileal carcinoid tumors is a rarely described pathologic mucosal transformation that may simulate inflammatory or neoplastic polyps. We describe a case with innumerable sessile polyps and groups of large filiform-like polyps of the terminal ileum associated with submucosal carcinoid tumors and a large mesenteric carcinoid tumor mass. The clinical, radiographic, and endoscopic presentation of the polyposis, together with the presence of multiple small bowel stenotic lesions, simulated crohn disease. We propose the descriptive terminology angiomatous polyposis to describe the striking microscopic vascular proliferation that characterizes these polyps. The distribution of these lesions, with the most profuse polyposis in the immediate proximity of the carcinoid nests, and the immunohistochemical demonstration of growth factor substances, such as transforming growth factor alpha within neoplastic cells and adjacent polyps, suggest a tumor factor-mediated stromal proliferation.- - - - - - - - - - ranking = 0.16666666666667keywords = bowel (Clic here for more details about this article) |
9/207. Pseudogastroparesis as a presentation of small-bowel malignancy.Establishing the diagnosis of small-bowel malignancy is sometimes an extremely difficult challenge owing to its non-specific symptoms. The mainstay of treatment is early recognition, diagnosis and surgical resection. The prognosis depends primarily on the degree of spread and stage at presentation. We present two cases with initially obscure presentations of a small-bowel tumour. One was a jejunal adenocarcinoma, but an initial upper gastrointestinal and small-bowel series did not disclose the lesion; the other was a primary ileal lymphoma, first thought to be diabetes mellitus gastroparesis. Therefore, a negative small-bowel series or presentation of a systemic disease-associated intestinal pseudo-obstruction or gastroparesis does not exclude the possibility of a small-bowel malignancy, if the clinical symptoms are not alleviated after prokinetic medications. The clinicians should further pursue the possibility of an obstructing lesion.- - - - - - - - - - ranking = 1.5keywords = bowel (Clic here for more details about this article) |
10/207. Perforation--a rare complication of a small-bowel carcinoid.Carcinoids are rare compared to other tumours of the gastrointestinal tract, but present a significant portion of tumours of the small intestine. The case of a 50-year-old man who suffered perforation of a small-bowel carcinoid after failed diagnostic trials is reported here. Since intestinal perforation is rarely the first sign of the presence of a carcinoid, it is useful to bear this in mind when dealing with unclear pathological changes of the small intestine.- - - - - - - - - - ranking = 0.83333333333333keywords = bowel (Clic here for more details about this article) |
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