Heterotopic bone formation(osseous metaplasia) is rarely detected in the gastrointestinal tract.Most of reported cases are associated with malignant lesions.We herein report a case of osseous metaplasia in a rectal in...Heterotopic bone formation(osseous metaplasia) is rarely detected in the gastrointestinal tract.Most of reported cases are associated with malignant lesions.We herein report a case of osseous metaplasia in a rectal inflammatory polyp and a review of the literature on suggested mechanisms for its aetiology.A 39-year-old man visited our hospital with a chief complaint of melena.Total colonoscopy revealed a slightly reddish subpedunculated polyp,about 12 mm in diameter,in the lower rectum.Endoscopic resection was performed.Histologically,several foci of heterotopic bone formation were found.From the review of the literature,all of the polyps described were larger than 10mm in diameter,55.6% showed inflammatory changes,and 62.5% were detected in the rectum.Osteogenic stimulation was considered to be a result of the inflammatory process.As our inflammatory polyp was located in the rectum,the pathogenesis could be a reactive change stimulated by the repeated local trauma,or be on a peculiar characteristic of the rectal mucosa itself.展开更多
Amyloidosis of the gastrointestinal tract is a rare disease that presents with common,nonspecific signs and symptoms.It may affect any part of the gastrointestinal tract from mouth to anus.The clinical and endoscopic ...Amyloidosis of the gastrointestinal tract is a rare disease that presents with common,nonspecific signs and symptoms.It may affect any part of the gastrointestinal tract from mouth to anus.The clinical and endoscopic features are diverse and may mimic other diseases,such as inflammatory bowel disease,malignancy,ischemic colitis and,at times,collagenous colitis.We describe an uncommon case of rectal bleeding and anemia with polypoid lesions and ulcerations in the colon,as the presenting symptom of AL amyloidosis and light chain multiple myeloma.展开更多
Rectal bleeding combined with the presence of a rectal mass has been traditionally associated with the presence of malignant disease.Cap polyposis is a relatively young and still undefined rare entity which mainly in... Rectal bleeding combined with the presence of a rectal mass has been traditionally associated with the presence of malignant disease.Cap polyposis is a relatively young and still undefined rare entity which mainly involves the rectosigmoid.It is characterized by the presence of inflammatory polyps.In this case report,we present a patient who was diagnosed with a solitary cap polyp of the rectum during the investigation of a bleeding rectal mass.The patient’s age and the absence of family history were not in favor of malignancy,despite the strong initial clinical impression.After confirmation of the diagnosis,the patient underwent a snare excision and remains asymptomatic.Cap polyposis,although rare,should be suspected and,when diagnosed,should be treated according to location,number of polyps and severity of symptoms.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)can be used for the en-bloc removal of superficial rectal lesions;however,the lack of a traction system makes the procedure long and difficult in the presence of extensi...BACKGROUND Endoscopic submucosal dissection(ESD)can be used for the en-bloc removal of superficial rectal lesions;however,the lack of a traction system makes the procedure long and difficult in the presence of extensive lesions.CASE SUMMARY A large polyp occupying 2/3 of the rectal circumference and extending 5 cm in length was removed by ESD with the help of laparoscopic forceps introduced via trans-anal rectoscopic assisted minimally invasive surgery,a disposable platform designed to aid in transanal minimally invasive surgery.Traction of the polyp by forceps during the operation was dynamic,and applied at various points and in various directions.The polyp was removed en-bloc without complications in 1 h and 55 min.A sigmoidoscopy performed 50 d later showed normal healing without polyp recurrence.CONCLUSION The technique presented here could overcome the issues caused by lack of traction during ESD for rectal lesions.展开更多
Solitary rectal ulcer syndrome(SRUS) is a rare benign condition, which can mimic many other diseases because of their similarities in clinical, endoscopic and histological features. Sessile serrated adenoma/polyp(SSA/...Solitary rectal ulcer syndrome(SRUS) is a rare benign condition, which can mimic many other diseases because of their similarities in clinical, endoscopic and histological features. Sessile serrated adenoma/polyp(SSA/p) is a premalignant lesion in the colon and rectum. The misdiagnosis of SSA/p in SRUS patients has been noted, but the case of SRUS arising secondarily to SSA/p has been rarely reported. We herein report the case of a 59-year-old man who presented with an ulcerative nodular lesion in the rectum, accompanied by the symptoms of blood and mucus in the feces, diarrhea and constipation. Magnetic resonance imagining revealed thickening of the rectal mucosa-submucosa. Histologically, the lesion was characterized by the hyperplastic lamina propria and diffusely serrated crypts. Further immunohistochemical staining showed the loss of HES1 and MLH1 expression in the epithelial cells in the serrated area. The patient with SRUS had histological changes of SSA/p, suggesting a potential of tumor transformation in certain cases. SRUS uncommonly accompanied by serrated lesions should at least be considered by pathologists and clinicians.展开更多
文摘Heterotopic bone formation(osseous metaplasia) is rarely detected in the gastrointestinal tract.Most of reported cases are associated with malignant lesions.We herein report a case of osseous metaplasia in a rectal inflammatory polyp and a review of the literature on suggested mechanisms for its aetiology.A 39-year-old man visited our hospital with a chief complaint of melena.Total colonoscopy revealed a slightly reddish subpedunculated polyp,about 12 mm in diameter,in the lower rectum.Endoscopic resection was performed.Histologically,several foci of heterotopic bone formation were found.From the review of the literature,all of the polyps described were larger than 10mm in diameter,55.6% showed inflammatory changes,and 62.5% were detected in the rectum.Osteogenic stimulation was considered to be a result of the inflammatory process.As our inflammatory polyp was located in the rectum,the pathogenesis could be a reactive change stimulated by the repeated local trauma,or be on a peculiar characteristic of the rectal mucosa itself.
文摘Amyloidosis of the gastrointestinal tract is a rare disease that presents with common,nonspecific signs and symptoms.It may affect any part of the gastrointestinal tract from mouth to anus.The clinical and endoscopic features are diverse and may mimic other diseases,such as inflammatory bowel disease,malignancy,ischemic colitis and,at times,collagenous colitis.We describe an uncommon case of rectal bleeding and anemia with polypoid lesions and ulcerations in the colon,as the presenting symptom of AL amyloidosis and light chain multiple myeloma.
文摘 Rectal bleeding combined with the presence of a rectal mass has been traditionally associated with the presence of malignant disease.Cap polyposis is a relatively young and still undefined rare entity which mainly involves the rectosigmoid.It is characterized by the presence of inflammatory polyps.In this case report,we present a patient who was diagnosed with a solitary cap polyp of the rectum during the investigation of a bleeding rectal mass.The patient’s age and the absence of family history were not in favor of malignancy,despite the strong initial clinical impression.After confirmation of the diagnosis,the patient underwent a snare excision and remains asymptomatic.Cap polyposis,although rare,should be suspected and,when diagnosed,should be treated according to location,number of polyps and severity of symptoms.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)can be used for the en-bloc removal of superficial rectal lesions;however,the lack of a traction system makes the procedure long and difficult in the presence of extensive lesions.CASE SUMMARY A large polyp occupying 2/3 of the rectal circumference and extending 5 cm in length was removed by ESD with the help of laparoscopic forceps introduced via trans-anal rectoscopic assisted minimally invasive surgery,a disposable platform designed to aid in transanal minimally invasive surgery.Traction of the polyp by forceps during the operation was dynamic,and applied at various points and in various directions.The polyp was removed en-bloc without complications in 1 h and 55 min.A sigmoidoscopy performed 50 d later showed normal healing without polyp recurrence.CONCLUSION The technique presented here could overcome the issues caused by lack of traction during ESD for rectal lesions.
基金Supported by the National Natural Science Foundation of China,No.81101806Natural Science Foundation of Shanghai,No.17ZR1406500
文摘Solitary rectal ulcer syndrome(SRUS) is a rare benign condition, which can mimic many other diseases because of their similarities in clinical, endoscopic and histological features. Sessile serrated adenoma/polyp(SSA/p) is a premalignant lesion in the colon and rectum. The misdiagnosis of SSA/p in SRUS patients has been noted, but the case of SRUS arising secondarily to SSA/p has been rarely reported. We herein report the case of a 59-year-old man who presented with an ulcerative nodular lesion in the rectum, accompanied by the symptoms of blood and mucus in the feces, diarrhea and constipation. Magnetic resonance imagining revealed thickening of the rectal mucosa-submucosa. Histologically, the lesion was characterized by the hyperplastic lamina propria and diffusely serrated crypts. Further immunohistochemical staining showed the loss of HES1 and MLH1 expression in the epithelial cells in the serrated area. The patient with SRUS had histological changes of SSA/p, suggesting a potential of tumor transformation in certain cases. SRUS uncommonly accompanied by serrated lesions should at least be considered by pathologists and clinicians.
