Clinical Endoscopy

Xanthogranulomatous Inflammation in Terminal Ileum Presenting as an Appendiceal Mass: Case Report and Review of the Literature: Jun Sik Yoon, Yong Cheol Jeon, Tae Yeob Kim, Dong Soo Han, Joo Hyun Sohn, Kil Woo Nam, Young Su Nam, Ju Yeon Pyo; Clin Endosc 2013;46(2):193-196. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.193

Xanthogranulomatous inflammation (XGI) is a rare benign inflammatory disease characterized by aggregation of lipid-laden foamy macrophages. This disease entity has been described in various organs but most commonly in the kidney and gallbladder. The occurrence of this disease in the lower gastrointestinal tract is extremely rare. Its clinical importance is that it can be misdiagnosed as an infiltrative cancer. In this case report, a 52-year-old male complained of right lower quadrant abdominal pain for a period of 3 months. Abdominal computed tomography revealed appendiceal mass and colonoscopy revealed multiple erythematous nodular lesions in the terminal ileum and appendiceal orifice, mimicking appendiceal cancer. Right hemicolectomy was done and the pathological specimen revealed XGI of the terminal ileum. To our knowledge, this is the first case of XGI in terminal ileum presenting as abdominal pain and the appendiceal mass on radiologic findings.

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56세 남자, 하복부 동통과 설사: Korean J Gastrointest Endosc 2003;26(5):354-354. Published online May 30, 2003

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Endoscopic Hemoclipping in a Terminal Ileal Dieulafoy's Lesion: Man Jo Kim, M.D., Jung Sup Eum, M.D., Hae Dong Park, M.D., Soo Hyun Kim, M.D., Sung Min Kim, M.D., Mi Ae Jo, M.D., Dong Ju Song, M.D., Se Lim Choi, M.D., Hee Seung Park, M.D. and Seong Ho Choi, M.D.; Korean J Gastrointest Endosc 2003;26(2):106-109. Published online February 28, 2003

Abstract PDF: Dieulafoy's lesion is an uncommon source of massive gastrointestinal hemorrhage. The lesion predominantly occurs in the proximal stomach, but may occur in all parts of the gastrointestinal tract including small bowel, colon and rectum. We herein report a case of a patient who presented with hematochezia from Dieulafoy's lesion of the terminal ileum with adherent blood clots. Bleeding was successfully controlled with endoscopic treatment by utilizing hemoclipping. (Korean J Gastrointest Endosc 2003;26:106⁣109)

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대장내시경으로 확인된 악성 림프종의 내시경적 분류와 임상병리학적 고찰 ( Clinicopathological Features of Malignant Lymphoma Detected by Colonoscopy : An Analysis According to the Endoscopic Classification ): Korean J Gastrointest Endosc 2001;23(1):21-27. Published online November 30, 2000

Abstract PDF: Background
/Alms: There have been only a few endoscopic s0dies of lower intestinal lesions of malignsnt lymphoma. The aims of this study were to classify the ileocolonic 1ymphomas according to the colonoscopic fhgdings and to reveal the dinicopathological relationship according to the classes. Methods: Subjects were 24 cases of ileocolonic lymphomas. We evaluated the clinicopathological features according to their endoscopic fmdings. Results: The chief complaints were abdominal pain, bleeding, and abdomina1 mess, Twenty-six lesions from 22 patients, excluding 2 multiple lymphomatous polyposis, were endoscopically classfled as follows. Fungating (10 lemons), ulcerofungating (7 lesions), inflltrative (5 lesions), ulceroinfiltrative (3 lesions), and ulcerative (1 lesion). The 1ocafim of the lesions was the terminal ileum in 11 lesions, the colon in 10 lesions, and both regions in 5 lesions. Within the 1arge bowel, the cecum was involved most frequently, followed by the ascending colon and the remainder. Most of pathological types were the diffuse large cell and the large cell immunoblastic. There was no relationship between the endoscopic findings and the histologic types. Eight eases were manifested as intussusceptlon. Conclasions: Ileocolonic lymphomas can be classified endoscopically into five types. Among the types, fungating and ulcerofungating types axe the most frequent. (Korean J Gastrointest Eadosc 2001;23:21-27)

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구연 / 포스터 : Small Bowel Bezoar Complicated with Intestinal Obstruction: Korean J Gastrointest Endosc 2001;22(5):361-361. Published online November 30, 2000

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내시경적 전기응고술로 치료한 회장 말단의 Dieulafoy 양 병변 1 예 ( A Case of Dieulafoy`s Lesion of the Terminal Ileum Treated by Colonoscopic Electrocoagulation ): Korean J Gastrointest Endosc 2001;23(6):499-502. Published online November 30, 2000

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성인에서 발생한 소장의 Burkitt 림프종 1 예 ( A Case of Small Intestinal Burkitt`s Lymphoma in an Adult ): Korean J Gastrointest Endosc 2001;22(6):435-439. Published online November 30, 2000

Abstract PDF: Burkitt`s lymphoma is a rare disease that belongs to the aggressive non-Hodgkin`s lymphomas. Burkitt`s lymphoma usually occurs in children or younger persons. There is a strong association between endemic Burkitt's lymphoma and Epstein-Barr virus, whereas the association is weaker in the sporadic form occurring in Western countries. Burkitt`s lymphoma of the gastrointestinal tract occurring in adults has not been reported in Korea. We herein report an unusual case of Burkitt's lymphoma presenting with a palpable abdominal mass in a 52-year-old man infected with Epstein-Barr virus. A computed tomographic scan showed marked low density wall thickening of the terminal ileum. An endoscopy revealed a narrow lumen, shallow ulcerations, and irregular nodularity of the terminal ileum. Small bowel resection and hemicolectomy were performed and a histologic examination of the resected specimen confirmed the diagnosis. Six cycles of adjuvant chemotherapy were given and the patient has been doing well without evidence of recurrence. (Korean J Gastrointest Endosc 2001;22:435-439)

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메켈씨 장석(Meckel's Enterolith) 1예 ( A Case of Meckel's Enterolith ): Korean J Gastrointest Endosc 1999;19(4):643-651. Published online November 30, 1998

Abstract PDF: Most intussusceptions occur in children under 1 year of age whereas 5%∼10% occurs in adults. Although intussusception has an acute occurrence in children, symptoms in adults may be subacute or chronic, and the diagnosis is often delayed. In contrast to adults, intussusception in children is the most common cause of intestinal obstruction, and one of the most frequent causes of surgical emergencies. While idiopathic cases account for more than 90% of those seen in children, many cases in adults are generally related to neoplasm. However, intussusception due to a primary malignant lymphoma of the small intestine is a rare clinical condition. There is little information on the role of colonoscopy in colonic intussusception. Two cases are herein reported, of malignant lymphoma in the ileocecal region causing intussusceptions in which the diagnosis and reduction of intussusception were made by colonoscopy. Colonoscopy plays a useful role in the diagnosis and management of intussusception. The clinical, radiographic, endoscopic, and pathologic findings are described with brief reviews of related literature. (Korean J Gastrointest Endosc 19: 650∼655, 1999)

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증례 : 식도 위장관 ; 위와 회장말단부에 발생한 Hodgkin 씨병 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Hodgkin's Disease Involved in the Stomach and Terminal Ileum ): Korean J Gastrointest Endosc 1998;18(6):922-929. Published online November 30, 1997

Abstract PDF: Cases with extranodal Hodgkin's disease located in sites outside those defined as lymphatic structure are quite rare. The exact incidence of this localized form of Hodgkin's disease is unknown, but it is estimated to be only 0.25% for overall incidence of Hodgkin's disease. Localized primary extranodal Hodgkin's disease seems to have an excellent prognosis in some cases including skin, tongue, lung, stomach, small bowel, and thyroid. We report a case of primary gastrointestinal Hodgkin's disease involved in the stomach and terminal ileum in 48-year-old man with 7 kg of weight loss for 3 months, fever with chills for 1 week, and intermittent epigastric pain for 1 year. The histologic type of this case was lymphocyte predominance, which was diagnosed by biopsy of the stomach and terminal ileum with immnophenotyping study. And the stage of this case was IIE. We tried combination chemotherapy with adriamycin, bleomycin, vinblastin, and dacabazine with excellent response. For its rarity, we report this case with review of literatures. (Korean J Gastrointest Endosc 18: 922-927, 1998)

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