We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma.The patient initially presented with anemia and melena.Consecutive endoscopy revealed no signs of upper or lower active gastro...We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma.The patient initially presented with anemia and melena.Consecutive endoscopy revealed no signs of upper or lower active gastrointestinal bleeding.The patient had been diagnosed 3 years previously with an aortic dilation,which was treated with a stent.Computed tomography suggested an aorto-intestinal fistula as the cause of the intestinal bleeding,leading to operative stent explantation and aortic replacement.However,an aorto-intestinal fistula was not found,and the intestinal bleeding did not arrest postoperatively.The constant need for blood transfusions made an exploratory laparotomy imperative,which showed multiple bleeding sites,predominately in the jejunal wall.A distal loop jejunostomy was conducted to contain the small intestinal bleeding and a segmental resection for histological evaluation was performed.The histological analysis revealed a lessdifferentiated tumor with characteristic CD31,cytokeratin,and vimentin expression,which led to the diagnosis of small intestinal angiosarcoma.Consequently,the infiltrated part of the jejunum was successfully resected in a subsequent operation,and adjuvant chemotherapy with paclitaxel was planned.Angiosarcoma of the small intestine is an extremely rare malignant neoplasm that presents with bleeding and high mortality.Early diagnosis and treatment are essential to improve outcome.A small intestinal angiosarcoma is a challenging diagnosis to make because of its rarity,nonspecific symptoms of altered intestinal function,nonspecific abdominal pain,severe melena,and acute abdominal signs.Therefore,a quick clinical and histological diagnosis and decisive measures including surgery and adjuvant chemotherapy should be the aim.展开更多
Spondyloarthropathies （SPA） are commonly observed extra-intestinal manifestations of both Crohn＇s disease （CD） and ulcerative colitis （UC）, the two major forms of inflammatory bowel diseases （[BD）. However, t...Spondyloarthropathies （SPA） are commonly observed extra-intestinal manifestations of both Crohn＇s disease （CD） and ulcerative colitis （UC）, the two major forms of inflammatory bowel diseases （[BD）. However, the immunological link between these two clinical entities is still poorly understood. Several lines of evidence indicate that SpA may originate from the relocation to the joints of the immune process primarily induced in the gut. The transfer of the intestinal inflammatory process into the joints implicates that immune cells activated in the gut-draining lymph nodes can localize, at a certain point of the intestinal disease, either into the gut or into the joints. This is indicated by the overlapping expression of adhesion molecules observed on the surface of intestinal and synovial endothelial cells during inflammation. Moreover bacterial antigens and HLA-B27 expression may be implicated in the reactivation of T cells at the articular level. Finally, accumulating evidence indicates that a T helper 17 cell-mediated immune response may contribute to IBD and IBD-related SpA with a crucial role played by tumor necrosis factor-α in CD and to a lesser extent in UC.展开更多
Introduction Lymphangioma is a rare benign tumor of lymphatic vessel origin. The tumor often appears in the head and neck region at a young age and can occasionally be found in the abdomen of adults with protean degre...Introduction Lymphangioma is a rare benign tumor of lymphatic vessel origin. The tumor often appears in the head and neck region at a young age and can occasionally be found in the abdomen of adults with protean degrees of symptoms depending on the tumor size and location. How- ever, lymphangioma of the small intestine is extremely rare with only a few cases reported in the literature. As the tumor is not well-recog- nized, many patients with small intestine lymphangioma have been given an incorrect preoperative diagnosis. The ideal treatment for the disease is surgical excision, and the prognosis is comparatively good. In this paper, we report a rare case of ileal lymphangioma with gas- trointestinal hemorrhage preoperatively diagnosed using enteroscopy and treated with surgery.展开更多
文摘We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma.The patient initially presented with anemia and melena.Consecutive endoscopy revealed no signs of upper or lower active gastrointestinal bleeding.The patient had been diagnosed 3 years previously with an aortic dilation,which was treated with a stent.Computed tomography suggested an aorto-intestinal fistula as the cause of the intestinal bleeding,leading to operative stent explantation and aortic replacement.However,an aorto-intestinal fistula was not found,and the intestinal bleeding did not arrest postoperatively.The constant need for blood transfusions made an exploratory laparotomy imperative,which showed multiple bleeding sites,predominately in the jejunal wall.A distal loop jejunostomy was conducted to contain the small intestinal bleeding and a segmental resection for histological evaluation was performed.The histological analysis revealed a lessdifferentiated tumor with characteristic CD31,cytokeratin,and vimentin expression,which led to the diagnosis of small intestinal angiosarcoma.Consequently,the infiltrated part of the jejunum was successfully resected in a subsequent operation,and adjuvant chemotherapy with paclitaxel was planned.Angiosarcoma of the small intestine is an extremely rare malignant neoplasm that presents with bleeding and high mortality.Early diagnosis and treatment are essential to improve outcome.A small intestinal angiosarcoma is a challenging diagnosis to make because of its rarity,nonspecific symptoms of altered intestinal function,nonspecific abdominal pain,severe melena,and acute abdominal signs.Therefore,a quick clinical and histological diagnosis and decisive measures including surgery and adjuvant chemotherapy should be the aim.
文摘Spondyloarthropathies （SPA） are commonly observed extra-intestinal manifestations of both Crohn＇s disease （CD） and ulcerative colitis （UC）, the two major forms of inflammatory bowel diseases （[BD）. However, the immunological link between these two clinical entities is still poorly understood. Several lines of evidence indicate that SpA may originate from the relocation to the joints of the immune process primarily induced in the gut. The transfer of the intestinal inflammatory process into the joints implicates that immune cells activated in the gut-draining lymph nodes can localize, at a certain point of the intestinal disease, either into the gut or into the joints. This is indicated by the overlapping expression of adhesion molecules observed on the surface of intestinal and synovial endothelial cells during inflammation. Moreover bacterial antigens and HLA-B27 expression may be implicated in the reactivation of T cells at the articular level. Finally, accumulating evidence indicates that a T helper 17 cell-mediated immune response may contribute to IBD and IBD-related SpA with a crucial role played by tumor necrosis factor-α in CD and to a lesser extent in UC.
文摘Introduction Lymphangioma is a rare benign tumor of lymphatic vessel origin. The tumor often appears in the head and neck region at a young age and can occasionally be found in the abdomen of adults with protean degrees of symptoms depending on the tumor size and location. How- ever, lymphangioma of the small intestine is extremely rare with only a few cases reported in the literature. As the tumor is not well-recog- nized, many patients with small intestine lymphangioma have been given an incorrect preoperative diagnosis. The ideal treatment for the disease is surgical excision, and the prognosis is comparatively good. In this paper, we report a rare case of ileal lymphangioma with gas- trointestinal hemorrhage preoperatively diagnosed using enteroscopy and treated with surgery.
