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Filiform Polyposis Secondary to Colonic Tuberculosis Presenting as Acute Colo-Colonic Intussusception.

Heng JS, Baird A, Novelli MR, Davidson RN, Bhutiani RP - Case Rep Surg (2015)

Bottom Line: At last follow-up, he was awaiting the reversal of his ileostomy.The protean nature of histological findings in colonic tuberculosis and other current diagnostic challenges are discussed.The importance of maintaining a high index of suspicion for colonic tuberculosis and instituting early treatment is highlighted in this case.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Northwick Park Hospital, Harrow, London HA1 3UJ, UK ; Imperial College London Faculty of Medicine, London SW7 2AZ, UK.

ABSTRACT
Filiform polyposis represents a rare but recognised manifestation on the varied spectrum of histopathology in colonic tuberculosis. We report a case of filiform polyposis secondary to colonic tuberculosis presenting as colo-colonic intussusception diagnosed on an abdominal computed tomography (CT) scan. The patient required urgent hemicolectomy and defunctioning ileostomy. Examination of the resected bowel lesions revealed filiform polyposis. Induced sputum samples from the patient grew Mycobacterium tuberculosis. The patient recovered well from the surgery and received treatment for tuberculosis. At last follow-up, he was awaiting the reversal of his ileostomy. The protean nature of histological findings in colonic tuberculosis and other current diagnostic challenges are discussed. The importance of maintaining a high index of suspicion for colonic tuberculosis and instituting early treatment is highlighted in this case.

No MeSH data available.


Related in: MedlinePlus

Section from left hemicolectomy showing a constricting mass in the distal transverse colon (Label A) and an adjacent synchronous mass in the proximal descending colon (Label B). Filiform polyps (F) are seen within both lesions.
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fig4: Section from left hemicolectomy showing a constricting mass in the distal transverse colon (Label A) and an adjacent synchronous mass in the proximal descending colon (Label B). Filiform polyps (F) are seen within both lesions.

Mentions: Histology sections from the colonic lesion showed an area of florid filiform polyposis (Figure 4) with no evidence of dysplasia but with adjacent ulceration of the colonic mucosa. The background colon showed areas of transmural chronic inflammation in the form of subserosal lymphoid aggregates arranged in a rosary pattern (Figure 5). No AAFB, granulomas, features of colitis, or diverticular disease were identified. Multiple lymph nodes examined showed reactive-type changes only. The appearances were most in keeping with localised filiform polyposis.


Filiform Polyposis Secondary to Colonic Tuberculosis Presenting as Acute Colo-Colonic Intussusception.

Heng JS, Baird A, Novelli MR, Davidson RN, Bhutiani RP - Case Rep Surg (2015)

Section from left hemicolectomy showing a constricting mass in the distal transverse colon (Label A) and an adjacent synchronous mass in the proximal descending colon (Label B). Filiform polyps (F) are seen within both lesions.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4465708&req=5

fig4: Section from left hemicolectomy showing a constricting mass in the distal transverse colon (Label A) and an adjacent synchronous mass in the proximal descending colon (Label B). Filiform polyps (F) are seen within both lesions.
Mentions: Histology sections from the colonic lesion showed an area of florid filiform polyposis (Figure 4) with no evidence of dysplasia but with adjacent ulceration of the colonic mucosa. The background colon showed areas of transmural chronic inflammation in the form of subserosal lymphoid aggregates arranged in a rosary pattern (Figure 5). No AAFB, granulomas, features of colitis, or diverticular disease were identified. Multiple lymph nodes examined showed reactive-type changes only. The appearances were most in keeping with localised filiform polyposis.

Bottom Line: At last follow-up, he was awaiting the reversal of his ileostomy.The protean nature of histological findings in colonic tuberculosis and other current diagnostic challenges are discussed.The importance of maintaining a high index of suspicion for colonic tuberculosis and instituting early treatment is highlighted in this case.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Northwick Park Hospital, Harrow, London HA1 3UJ, UK ; Imperial College London Faculty of Medicine, London SW7 2AZ, UK.

ABSTRACT
Filiform polyposis represents a rare but recognised manifestation on the varied spectrum of histopathology in colonic tuberculosis. We report a case of filiform polyposis secondary to colonic tuberculosis presenting as colo-colonic intussusception diagnosed on an abdominal computed tomography (CT) scan. The patient required urgent hemicolectomy and defunctioning ileostomy. Examination of the resected bowel lesions revealed filiform polyposis. Induced sputum samples from the patient grew Mycobacterium tuberculosis. The patient recovered well from the surgery and received treatment for tuberculosis. At last follow-up, he was awaiting the reversal of his ileostomy. The protean nature of histological findings in colonic tuberculosis and other current diagnostic challenges are discussed. The importance of maintaining a high index of suspicion for colonic tuberculosis and instituting early treatment is highlighted in this case.

No MeSH data available.


Related in: MedlinePlus