Clinical Endoscopy

A large and pedunculated inflammatory pseudotumor with pseudosarcomatous change of the cecum mimicking a malignant polyp: a case report and literature review: Jong Suk Oh, Hyung Wook Kim, Su Bum Park, Dae Hwan Kang, Cheol Woong Choi, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu; Clin Endosc 2023;56(1):119-124. Published online July 19, 2021; DOI: https://doi.org/10.5946/ce.2021.081

Abstract PDF PubReader ePub: Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown etiology that can occur in almost any organ system. It has neoplastic features such as local recurrence, invasive growth, and vascular invasion, leading to the possibility of malignant sarcomatous changes. The clinical presentations of colonic IPT may include abdominal pain, anemia, a palpable mass, and intestinal obstruction. A few cases of colonic IPT have been reported, but colonic IPT with pedunculated morphology is very rare. Furthermore, since it can mimic malignant polyps, understanding the endoscopic findings of colonic IPT is important for proper treatment. Herein, we present a case of colonic IPT with pseudosarcomatous changes, presenting as a large polyp, mimicking a malignant polyp in the cecum, along with a literature review.

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Immunoglobulin G4-Related Inflammatory Pseudotumor Presenting as a Solitary Mass in the Stomach: Hong Ryeol Cheong, Bong Eun Lee, Geun Am Song, Gwang Ha Kim, Sung Gyu An, Won Lim; Clin Endosc 2016;49(2):197-201. Published online February 12, 2016; DOI: https://doi.org/10.5946/ce.2015.074

Immunoglobulin G4 (IgG4)-related disease (IgG4RD) is a relatively recently recognized entity that is histopathologically characterized by an extensive infiltration of lymphocytes and IgG4-positive plasma cells with dense fibrosis. IgG4RD is now known to affect any organ system, and a few cases of gastrointestinal lesions have also been reported. However, solitary IgG4RD of the stomach is still very rare. Furthermore, as it can mimic malignant conditions, it is important to recognize this disease to avoid unnecessary surgery. Herein, we present a case of IgG4RD presenting as an isolated subepithelial mass in the stomach.

Citations

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Clinicopathological characteristics of gastric IgG4‐related disease: Systematic scoping review
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Inflammatory Pseudotumor Causing Small Bowel Obstruction in a Patient with AIDS: Hyun Soo Kim, M.D., Jae Myung Cha, M.D., Joung Il Lee, M.D., Kwang Ro Joo, M.D., Hyun Joon Jung, M.D., Chi Hoon Lee, M.D., Sung-Jig Lim, M.D.* and Ki Yong Na, M.D.*; Korean J Gastrointest Endosc 2011;42(4):250-254. Published online April 28, 2011

Abstract PDF: Small bowel obstructions are most commonly caused by adhesions, hernias, neoplasms or inflammatory stricture. Inflammatory pseudotumors are an uncommon cause of small bowel obstruction, even in a patient with acquired immunodeficiency syndrome (AIDS). We have experienced a case of small bowel obstruction caused by an inflammatory pseudotumor in a 38-year old male with AIDS. Abdominal computed tomography showed small bowel obstruction due to jejunal annular wall thickening. Surgical laparotomy showed a non-specific granulomatous inflammatory mass that could not fulfill any diagnostic criteria for a specific disease. This report describes our findings of small bowel obstruction due to an inflammatory pseudotumor and discusses the differential diagnosis of inflammatory pseudotumor in AIDS patients. (Korean J Gastrointest Endosc 2011;42:250-254)

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Calcifying Fibrous Pseudotumor of the Stomach That Was Diagnosed by Endoscopic Submucosal Dissection: Dong Yeub Eun, M.D., Yong Dae Park, M.D., Dong Wook Lee, M.D., Jung Soo Lee, M.D., Jong Kyu Kwon, M.D., Seung Min Shin, M.D., Sang Man Park, M.D. and Kyung Rak Sohn, M.D.*; Korean J Gastrointest Endosc 2009;39(4):230-235. Published online October 30, 2009

Abstract PDF: Calcifying fibrous pseudotumor (CFPT) is very rare and especially at an intrinsic visceral location such as the stomach. The CFPT is generally located in the subcutaneous or deep soft tissue and the subserosal area of organs and it is mainly diagnosed during childhood or young adulthood. The etiology and pathophysiology of CFPT are unclear. Herein we describe a case of gastric CFPT and we review the related literature. A thirty-year-old asymptomatic female patient visited our hospital for the evaluation of a submucosal tumor that was seen on previous endoscopy. On the endoscopic ultrasonography (EUS), a subepithelial lesion was found at the gastric angle and it was a slightly hypoechoic, homogenous mass located at the submucosal layer of the gastric wall. Endoscopic submucosal dissection was performed under the suspicion of carcinoid. On the microscopic findings, most of the tissue was composed of hyalinized collagenous tissue. Mild lymphocytic infiltration and several dystrophic calcifications were also seen. Immunohistochemically, bcl-2 and CD34 staining was negative, so we diagnosed the mass as CFPT. (Korean J Gastrointest Endosc 2009;39:230-235)

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구연 / 포스터 : 식도의 종양성 병변과 유사한 식도결핵: Korean J Gastrointest Endosc 2001;22(5):340-340. Published online November 30, 2000

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악성종양과 유사한 형태를 보인 S 상 결장 게실염 1 예 ( A Case of Diverticulitis of Sigmoid Colon Mimicking Carcinoma ): Korean J Gastrointest Endosc 2001;23(4):255-258. Published online November 30, 2000

Abstract PDF: Diverticular disease of the colon in Korea is different from developed Western countries. Diverticulosis leads to the complications in about 20% of cases. The diverticulitis of the right colon is difficult to be differentiated from acute appendicitis. According as increase of elderly populations, incidence of the diverticulitis of the left colon increase. Therefore we should be differenciated from other diseases. In very rare case, frequent recurrence and recovery of the diverticulitis leads to a chronic state with complications such perforation, microabscess, fistula, adhesion and fibrous hypertrophy. These findings may be misdiagnosed as malignancy because of protruding mass and stricture on colonoscopy. We present a case of an pseudotumor that looks like a malignancy in the sigmoid on colonoscopy. After surgical resection, the lesion turned out to be a complicated diverticulitis. (Korean J Gastrointest Endosc 2001;23:255-258)

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