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Ileocecal intussusception with histomorphological features of inflammatory neuropathy in adenovirus infection.

Kaemmerer E, Tischendorf JJ, Steinau G, Wagner N, Gassler N - Gastroenterol Res Pract (2010)

Bottom Line: Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception.Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus.To our knowledge, this is the first report suggesting peristalsis disorders from inflammatory neuropathy as additional mechanism in the pathophysiological concept of adenovirus-associated ileocecal intussusception.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, RWTH Aachen University, 52074 Aachen, Germany.

ABSTRACT
The pathophysiological mechanisms for ileocecal intussusception in children with adenovirus infection are not well characterized. Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception. Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus. To our knowledge, this is the first report suggesting peristalsis disorders from inflammatory neuropathy as additional mechanism in the pathophysiological concept of adenovirus-associated ileocecal intussusception.

No MeSH data available.


Related in: MedlinePlus

Morphological aspects of ileocecal surgical specimens with intussusception; (a)–(d) Patient 1 (adenovirus infection); (e) Patient 2 (adenovirus infection); (f) Patient 3 (no adenovirus infection). (a) Ileocecal specimen with polypoid intraluminal tumour nodules (arrowhead). The appendix is marked by an arrow. Barr indicates 1 cm. (b)  Transmural tissue section of the terminal ileum displaying lymphoid hyperplasia with diffuse lymphocytic infiltration. H/E; original magnification 50×. (c) Dense lymphocytic infiltrates in strong vicinity to nervous plexus with ganglia (arrowheads). Lymphocytes accumulate in subserosal connective tissues. H/E; original magnification 200×. (d)  Anti-CD3 immunohistochemistry demonstrates T-lymphocytes in strong vicinity to the intramural plexus cells (plexus border is marked by dotted line). Small vessels crossing the plexus are marked with arrowheads. Original magnification 400×. (e) Tissue section of the terminal ileum (patient 2) demonstrates the plexus myentericus (dotted line) and several infiltrating lymphocytes and eosinophiles (arrowheads). H/E; original magnification 400×. (f) Transmural ileal tissue section (patient 3, adenovirus negative intussusception) with only mild lymphoid hyperplasia and few infiltrating lymphocytes (the nervous plexus is marked by arrowheads). Inset: Strong accumulation of erythrocytes adjacent to the nervous plexus (dotted line), but morphological features of inflammatory neuropathy are not visible. H/E; original magnification 50×; inset 400×.
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fig1: Morphological aspects of ileocecal surgical specimens with intussusception; (a)–(d) Patient 1 (adenovirus infection); (e) Patient 2 (adenovirus infection); (f) Patient 3 (no adenovirus infection). (a) Ileocecal specimen with polypoid intraluminal tumour nodules (arrowhead). The appendix is marked by an arrow. Barr indicates 1 cm. (b) Transmural tissue section of the terminal ileum displaying lymphoid hyperplasia with diffuse lymphocytic infiltration. H/E; original magnification 50×. (c) Dense lymphocytic infiltrates in strong vicinity to nervous plexus with ganglia (arrowheads). Lymphocytes accumulate in subserosal connective tissues. H/E; original magnification 200×. (d) Anti-CD3 immunohistochemistry demonstrates T-lymphocytes in strong vicinity to the intramural plexus cells (plexus border is marked by dotted line). Small vessels crossing the plexus are marked with arrowheads. Original magnification 400×. (e) Tissue section of the terminal ileum (patient 2) demonstrates the plexus myentericus (dotted line) and several infiltrating lymphocytes and eosinophiles (arrowheads). H/E; original magnification 400×. (f) Transmural ileal tissue section (patient 3, adenovirus negative intussusception) with only mild lymphoid hyperplasia and few infiltrating lymphocytes (the nervous plexus is marked by arrowheads). Inset: Strong accumulation of erythrocytes adjacent to the nervous plexus (dotted line), but morphological features of inflammatory neuropathy are not visible. H/E; original magnification 50×; inset 400×.

Mentions: The surgical specimen included 4 cm ileal and 6 cm colon segments, 8 cm appendix, and 3 cm mesenteric fatty tissue. Adjacent to Bauhin's valve, ileal mucosa displayed a macro- and micronodular polypoid mass with a maximal diameter of approximately 8 cm (Figure 1(a)). The gyrated surface structure included some tissue erosions and morphological features of chronic tissue damage and bleeding. Diffuse thickening of the intestinal wall and micronodular transformation of serosa tissues were focally visible.


Ileocecal intussusception with histomorphological features of inflammatory neuropathy in adenovirus infection.

Kaemmerer E, Tischendorf JJ, Steinau G, Wagner N, Gassler N - Gastroenterol Res Pract (2010)

Morphological aspects of ileocecal surgical specimens with intussusception; (a)–(d) Patient 1 (adenovirus infection); (e) Patient 2 (adenovirus infection); (f) Patient 3 (no adenovirus infection). (a) Ileocecal specimen with polypoid intraluminal tumour nodules (arrowhead). The appendix is marked by an arrow. Barr indicates 1 cm. (b)  Transmural tissue section of the terminal ileum displaying lymphoid hyperplasia with diffuse lymphocytic infiltration. H/E; original magnification 50×. (c) Dense lymphocytic infiltrates in strong vicinity to nervous plexus with ganglia (arrowheads). Lymphocytes accumulate in subserosal connective tissues. H/E; original magnification 200×. (d)  Anti-CD3 immunohistochemistry demonstrates T-lymphocytes in strong vicinity to the intramural plexus cells (plexus border is marked by dotted line). Small vessels crossing the plexus are marked with arrowheads. Original magnification 400×. (e) Tissue section of the terminal ileum (patient 2) demonstrates the plexus myentericus (dotted line) and several infiltrating lymphocytes and eosinophiles (arrowheads). H/E; original magnification 400×. (f) Transmural ileal tissue section (patient 3, adenovirus negative intussusception) with only mild lymphoid hyperplasia and few infiltrating lymphocytes (the nervous plexus is marked by arrowheads). Inset: Strong accumulation of erythrocytes adjacent to the nervous plexus (dotted line), but morphological features of inflammatory neuropathy are not visible. H/E; original magnification 50×; inset 400×.
© Copyright Policy - open-access
Related In: Results  -  Collection

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fig1: Morphological aspects of ileocecal surgical specimens with intussusception; (a)–(d) Patient 1 (adenovirus infection); (e) Patient 2 (adenovirus infection); (f) Patient 3 (no adenovirus infection). (a) Ileocecal specimen with polypoid intraluminal tumour nodules (arrowhead). The appendix is marked by an arrow. Barr indicates 1 cm. (b) Transmural tissue section of the terminal ileum displaying lymphoid hyperplasia with diffuse lymphocytic infiltration. H/E; original magnification 50×. (c) Dense lymphocytic infiltrates in strong vicinity to nervous plexus with ganglia (arrowheads). Lymphocytes accumulate in subserosal connective tissues. H/E; original magnification 200×. (d) Anti-CD3 immunohistochemistry demonstrates T-lymphocytes in strong vicinity to the intramural plexus cells (plexus border is marked by dotted line). Small vessels crossing the plexus are marked with arrowheads. Original magnification 400×. (e) Tissue section of the terminal ileum (patient 2) demonstrates the plexus myentericus (dotted line) and several infiltrating lymphocytes and eosinophiles (arrowheads). H/E; original magnification 400×. (f) Transmural ileal tissue section (patient 3, adenovirus negative intussusception) with only mild lymphoid hyperplasia and few infiltrating lymphocytes (the nervous plexus is marked by arrowheads). Inset: Strong accumulation of erythrocytes adjacent to the nervous plexus (dotted line), but morphological features of inflammatory neuropathy are not visible. H/E; original magnification 50×; inset 400×.
Mentions: The surgical specimen included 4 cm ileal and 6 cm colon segments, 8 cm appendix, and 3 cm mesenteric fatty tissue. Adjacent to Bauhin's valve, ileal mucosa displayed a macro- and micronodular polypoid mass with a maximal diameter of approximately 8 cm (Figure 1(a)). The gyrated surface structure included some tissue erosions and morphological features of chronic tissue damage and bleeding. Diffuse thickening of the intestinal wall and micronodular transformation of serosa tissues were focally visible.

Bottom Line: Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception.Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus.To our knowledge, this is the first report suggesting peristalsis disorders from inflammatory neuropathy as additional mechanism in the pathophysiological concept of adenovirus-associated ileocecal intussusception.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, RWTH Aachen University, 52074 Aachen, Germany.

ABSTRACT
The pathophysiological mechanisms for ileocecal intussusception in children with adenovirus infection are not well characterized. Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception. Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus. To our knowledge, this is the first report suggesting peristalsis disorders from inflammatory neuropathy as additional mechanism in the pathophysiological concept of adenovirus-associated ileocecal intussusception.

No MeSH data available.


Related in: MedlinePlus