[27年后放射引起的深囊性结肠炎。病例报告)。

José Gustavo García-Acosta, Erika Guadalupe Castañeda-Ángeles
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引用次数: 0

摘要

背景:深囊性结肠炎是一种罕见的结肠和直肠乙状结肠的良性病变。组织学上表现为腺体囊性扩张,伴粘蛋白产生并延伸穿过结肠壁,穿透粘膜肌层、粘膜下层,甚至固有肌层。我们报告一例深囊性结肠炎发生在辐射引起的结肠狭窄。临床病例:66岁女性,宫颈IA2期鳞状细胞癌病史,在化疗和放疗的同时行根治术治疗。用钴60进行特定剂量的外部光束辐射。27年后,患者出现腹泻大便约7次并腹胀。体检时,在乙状结肠发现肿瘤;她被转诊到一家三级医院;行左横环结肠造口术及乙状结肠切除术。在病理分析中,接受直肠乙状结肠切除术,发现狭窄区,粘膜有光泽,管壁增厚。镜下可见粘膜下囊肿充满大小不等的粘蛋白,被一层浸润结肠壁的无异型性上皮所覆盖。结论:深囊性结肠炎是一种良性非肿瘤性疾病。了解与放射史相关的这种病理实体是很重要的,因为文献中很少有病例报道。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Colitis cystica profunda induced by radiation 27 years later. Case report].

Background: Colitis cystica profunda is a rare and infrequent benign lesion of the colon and rectum-sigmoid colon. Histologically, it is characterized by glandular cystic dilatation with mucin production and extension through the colonic wall, penetrating the muscularis mucosae, submucosa, and even the muscularis propria. We report a case of colitis cystica profunda that occurred in a radiation-induced colonic stenosis.

Clinical case: A 66-year-old woman with a history of stage IA2 squamous cell carcinoma of the cervix, treated with conization in addition to simultaneous chemotherapy and radiotherapy. External beam radiation with cobalt60 was administered at specific doses. 27 years later, she presented diarrheal stools approximately 7 times with abdominal distension. On physical examination, a tumor was found in the sigmoid colon; she was referred to a third-level hospital; a colostomy in the left transverse loop and sigmoidectomy were performed. In the pathological analysis, a Rectosigmoidectomy product was received and a zone of stenosis with shiny mucosa and thickening of the wall was found. Microscopically, submucosal cysts filled with mucin of variable size were found, covered by a layer of epithelium without atypia that infiltrated the colonic wall.

Conclusions: Colitis cystica profunda is a benign non-neoplastic disease. Knowledge of this pathological entity associated with a history of radiation is important since there are few cases reported in the literature.

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