Jejunal Polyps with Unique Histopathological Characteristics Causing Invaginations, Report of a Case Nobuhiko Ohkawa 1 , Toshiyuki Yamatani 1 , Mamoru Nakamura 2 , Motoo Imanaka 3 , Takahiro Fujimori 3 1Department of Internal Medicine, Kasai Municipal Hospital 2Department of Surgery, Kasai Municipal Hospital 3The Second Department of Pathology, School of Medicine, Kobe University Keyword: 腸重積症 , 空腸ポリープ , 特異な病理像 pp.1304-1310
Published Date 1991/11/25
DOI https://doi.org/10.11477/mf.1403102698
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 A 16-year-old female with congenital aniridia was admitted to our hospital because of upper abdominal pain, repeated nausea and vomiting. The upper gastrointestinal x-ray series and endoscopic examination demonstrated a Yamada type Ⅳ polyp (diameter 3 cm approximately) in the jejunum 10 to 20 cm anal to the Treitz's ligament and obstruction of the lumen on the anal side of the polyp (Figs. 1 and 2). Ultrasonic and computed tomographic studies (Figs. 3 and 4) showed typical signs of jejuno-jejunal invagination with an intraluminal polyp at the leading point.

 Surgical operation was carried out. There were multiple polyps with a stalk or substalk within the jejunal lumen, 20 cm in length, around the invaginated portion. Adjacent portion of the jejunum, 30 cm in length, with the polyps was resected (Fig. 5).

 Histopathological studies showed formation of the protrusion caused by submucosal edema, adhesion and disappearance of the villi of muco-epithelium, papillaryform proliferation, hyperplasticity of surface epithelium, protrusion formed by stretching of the submucosal layer and partial erosion. There were no findings suggesting any epithelial atypia at all (Figs. 6 and 7).

 There have been no reports on jejunal polyps with such characteristic histopathological findings as in this case. It is well known that aniridia, which this patient also suffered from, sometimes complicates Wilms' tumor or some chromosomal aberrations. Therefore, it could be considered that chromosomal abnormalities are related to the occurrence of such unique polyps as seen in this case; in this particular case, however, we could not find chromosomal abnormalities.

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