Colitis cystica profunda occurring in a radiation-induced colonic stricture

Localized colitis cystica profunda developed in a fibrotic radiation-induced colonic stricture 17 years after pelvic radiation for squamous carcinoma of cervix. This uncommon pathologic entity must be distinguished from invasive adenocarcinoma of colon, and colonic radiation injury should be included with other conditions associated with colitis cystica profunda.     

Gastritis cystica profunda

Fourteen cases of gastritis cystica polyposa, four gastric adenomas and 25 'mature' erosions removed by diathermy at endoscopy were studied by light microscopy. Twenty surgical resections from gastric cancer patients and 18 gastric resections from gastroenterostomy patients previously operated upon for benign lesions were also studied. The mucosa showed consistent changes which were grouped as 'gastritis cystica superficialis'. Most surgical specimens, three out of 25 'mature' erosions, the four adenomas, and eight cases of gastritis cystica polyposa showed cystic gastric glands within the submucosa, closely resembling the changes seen in colitis cystica profunda. Thus the term 'gastritis cystica profunda' is proposed. It is suggested that ischaemia and chronic inflammation as well as the effects of surgery and presence of suture material have a role in the pathogenesis of gastritis cystica profunda. A correlation seems to exist between gastritis cystica profunda and gastric cancer.     

Enteritis cystica profunda

In addition to hamartomatous polyps of the small intestine, a patient with Peutz-Jeghers disease had gross and microscopic lesions of the ileum that were analogous to colitis cystica profunda in the large intestine and rectum. To the authors' knowledge, this is the first such case in an adult to be reported. They suggest the designation, "enteritis cystica profunda." The histology of the lesions and their association with a disease known to produce hamartomatous lesions lend support to the proposition that some cases of colitis cystica are also hamartamatous. It is also believed that some reported cases of small-intestinal adenocarcinoma in patients with Peutz-Jeghers syndrome are in reality examples of the benign process of enteritis cystica profunda.     

Colitis cystica profunda indefinite for dysplasia in Crohn disease: A potential diagnostic pitfall

Colitis cystica profunda (CCP) is a nonneoplastic condition characterized by misplaced glands deep to the muscularis mucosae of the colon and may be difficult to differentiate from well-differentiated mucinous adenocarcinoma. Absence of dysplasia in CCP usually aids in this distinction. We present a challenging case of CCP in the setting of Crohn disease (CD) containing foci of atypical epithelium. A right hemicolectomy from a 46-year-old woman contained a stricture associated with a proximal multilocular cystic lesion containing mucin-filled glands dissecting through the colonic wall. These glands had lobulated architecture with smooth contours surrounded by lamina propria and lacking desmoplastic stroma. The epithelium had focal nuclear crowding, enlargement, and hyperchromasia, with increased nucleus to cytoplasm ratio, but overall preserved polarity. Atypical cells were focally positive for CK7 and p53, with increased MIB-1 staining. These findings were interpreted as indefinite for dysplasia. Chronic transmural inflammation and mucosal regeneration probably facilitated epithelial misplacement, which secondarily developed cytologic atypia. However, the overall architecture and lack of dysplasia in the overlying mucosa argue against a diagnosis of adenocarcinoma. Our case illustrates the difficult diagnosis of this uncommon but problematic phenomenon, awareness of which is paramount for pathologists and clinicians participating in the management of CD patients.     

Enteritis cystica profunda: association with Crohn's disease

Enteritis cystica profunda (ECP), an uncommon condition, is characterized by nonneoplastic cystic spaces within the wall of the small bowel. The cases of two patients who had ECP in association with Crohn's disease are reported, and the role of mucosal damage in the pathogenesis of ECP is discussed. Pathologists must recognize this entity and distinguish it from adenocarcinoma, which may arise with increased frequency in the small bowel in patients with Crohn's disease.     

Enteritis cystica profunda in a patient with Crohn's disease

Colitis cystica profunda is an uncommon but well-recognized condition affecting the colon. Involvement of the small bowel, enteritis cystica profunda, is extremely rare, and is characterized by mucus-filled cystic spaces frequently lined by demonstrable epithelium. The cystic spaces are located within the submucosa and muscularis propria. Isolated cases have been described in association with Peutz-Jeghers syndrome and Crohn's disease. We report a case of enteritis cystica profunda in a 31-year-old man with Crohn's disease.     

Gastric collision tumor (carcinoid and adenocarcinoma) with gastritis cystica profunda

We report a rare case of gastric collision tumor (carcinoid and adenocarcinoma) with gastritis cystica profunda that developed in a 49-year-old Japanese man. Early gastric cancer (moderately differentiated tubular adenocarcinoma) was present at the edge of an ulcer in the posterior wall of the upper gastric body. In addition, a carcinoid tumor was found adjacent to adenocarcinoma. This tumor displayed ribbonlike or trabecular patterns, and numerous constituent cells were positive for the argyrophil reaction with Grimelius' stain and serotonin. Electron microscopic features of this tumor confirmed typical carcinoid. There was no merged appearance between both tumors, suggesting collision-type tumor.     

Extended gastritis cystica profunda associated with Epstein-Barr virus-positive dysplasia and carcinoma with lymphoid stroma

We report a case of gastritis cystica porfunda (GCP) associated with gastric carcinoma with lymphoid stroma (CLS). There was dysplastic change in the transitional area between GCP and CLS. Epstein-Barr virus (EBV) in situ hybridization (ISH) revealed positive reaction at the dysplastic area as well as at the CLS area. Immunohistochemical staining disclosed that dysplastic epithelium was similar to GCP in CK 20, MUC5AC, and E-cadherin expression, but similar to CLS in MUC6, CEA, p53, c-erb-B2, and EBV-ISH expression. Results of the EBV-ISH suggested that EBV infection may play a role in dysplastic change.     

Gastric inverted hyperplastic polyp. Report of four cases and relation to gastritis cystica profunda

Gastric inverted hyperplastic polyp (IHP) is a rare type of gastric polyp, and is characterized by downward growth of the hyperplastic mucosal components into the submucosa. To the best ofour knowledge, 16 gastric IHP cases have been described in the English literature, but the pathogenesis has not been established. We report the clinical and pathological findings of four gastric IHP cases. The lesions were mainly composed of hyperplastic foveolar-type glands with focal cystic dilatation. Pyloric type glands, endocrine cells, acinic cell metaplasia, and smooth muscle bundles were also seen as components of the polyp. Two cases (cases 1 and 4) coexisted with multifocal gastritis cystica profunda (GCP) and gastric adenocarcinoma. Case 4 furthermore exhibited an intermediate form between IHP and GCP. We suggest that IHP may be GCP associated with exaggeratedly hyperplastic and metaplastic changes. In case 4, the coexisting gastric carcinoma was mainly located in the submucosa, whilst the mucosal component was minimal. Five out of twenty reported gastric IHP cases, including our cases, coexisted with gastric adenocarcinoma. These facts would lead us to further investigate the relation between gastric IHP and carcinoma.     

Colitis cystica superficialis: a report of a case in a Barbary ape (Macaca sylvana).

A case of colitis cystica superficialis is described in a Barbary ape. Early mucosal herniations through the muscularis mucosae were identified, suggesting a possible relationship between this condition and colitis cystica profunda.     

Medionecrosis aortae idiopathica cystica

Ohne ZusammenfassungMit 9 Textabbildungen.