Pyogenic granuloma of the sigmoid colon

Gastrointestinal Pyogenic Granuloma (Lobular Capillary Hemangioma): An Underrecognized Entity Causing Iron Deficiency Anemia

Pyogenic granuloma (PG), more accurately known as lobular capillary hemangioma, is a benign vascular tumor that usually occurs in the skin or oral mucosa. This lesion is rarely reported in the gastrointestinal tract but is known to bleed if not resected. We herein describe a case series with the clinical, endoscopic, and histologic findings of four cases of gastrointestinal PG at our institution. In addition, we provide a review of the literature and summation of all reported cases of PG specific to the gastrointestinal tract. Based on our experience, we suggest that the actual incidence of gastrointestinal PG may in fact be higher than reported because PG can be unrecognized or improperly diagnosed. It is important for the clinician to properly recognize this lesion as a source of anemia and its propensity to bleed during biopsy or resection.

Coexistence of intestinal Kaposi sarcoma and plasmablastic lymphoma in an HIV/AIDS patient: case report and review of the literature

Human immunodeficiency virus (HIV) infection or acquired immunodeficiency disease (AIDS) is associated with increased risk for various malignancies including Kaposi sarcoma (KS) and lymphoma. We report a rare case of coexistence of KS and plasmablastic lymphoma (PBL) in the gastrointestinal (GI) tract in a HIV/AIDS patient. A brief review of literature is also presented.

Bleeding Small Intestine Pyogenic Granuloma on 18F-FDG PET/CT

A 53-year-old man with metastatic melanoma, in remission, presented with an 8-week history of melena and anemia. Initial investigations including upper and lower gastrointestinal endoscopy, capsule endoscopy, and Tc-labeled red blood cell scan did not reveal a source of bleeding. Given the concern over melanoma recurrence, F-FDG PET/CT was performed that demonstrated a focus of intense uptake in the small bowel. Uncomplicated surgical resection of the segment of jejunum containing the lesion was performed, after which the patient reported no further gastrointestinal bleeding. Histopathological assessment of the lesion was consistent with pyogenic granuloma.

Retroperitoneal lobular capillary hemangioma with synchronous ipsilateral renal cell carcinoma

Lobular capillary hemangiomas (LCH) are acquired benign vascular tumors of skin and mucosal spaces of head and neck. Very few cases of LCH have been reported in the abdomen, predominantly occurring as mucosal polyps in the bowel. We present CT imaging features of solitary retroperitoneal LCH in a patient with synchronous ipsilateral renal cell carcinoma and review the available literature and imaging features in abdominal and extra-abdominal LCH. To our knowledge, there is no other case of retroperitoneal LCH available in the English literature.

New insights into gastrointestinal and hepatic granulomatous disorders

Numerous diseases that involve the gastrointestinal tract reveal the presence of granulomas on histological analysis. Granulomatous diseases can be either primary or secondary to environmental factors. Granulomas are dynamic structures composed of organized collections of activated macrophages, including epithelioid and multinucleated giant cells, surrounded by lymphocytes. The formation of granulomas is usually in response to antigenic stimulation and is orchestrated through cytokines, immune cells and host genetics. In this Review, the pathogenesis and etiologies of granulomas of the gastrointestinal tract and liver are discussed, as are the available diagnostic tools to help differentiate their various underlying etiologies. In addition, the role of granulomas in harboring latent tuberculosis is reviewed. The effects of tumor necrosis factor antagonists and interferon-α on the development of granulomas are also discussed.

Pyogenic granuloma: an unusual cause of massive gastrointestinal bleeding from the small bowel

Small bowel hemorrhage is responsible for approximately 4% of all cases of gastrointestinal bleeding. The etiology of bleeding from the small bowel is a tumour in approximately 10% of cases. Pyogenic granuloma is a common inflammatory vascular tumour of the dermis, which rarely occurs in the gastrointestinal tract. Pyogenic granuloma is a rare cause of overt or obscure small bowel bleeding. The present paper reports the first case of pyogenic granuloma presenting as a massive gastrointestinal bleed, and reviews the relevant literature to date regarding the clinical presentation, diagnosis and management of this rare gastrointestinal lesion.

Pyogenic granuloma of the duodenum treated successfully by endoscopic mucosal resection

Pyogenic granuloma is a lobular capillary hemangioma that occurs mostly on the skin and the mucosal surfaces of the oral cavity and tongue. Only a few cases in other parts of the digestive tract have been reported. Gastrointestinal pyogenic granuloma is a rare cause of hemorrhage in the digestive tract, but should be considered in the differential diagnosis of patients with gastrointestinal bleeding. We report the case of a 62-year-old anemic woman found to have a pyogenic granuloma of the duodenum, which was treated adequately by endoscopic mucosal resection.

Gastrointestinal malignancies in HIV-infected or immunosuppressed patients: pathologic features and review of the literature

The gastrointestinal (GI) tract is a common internal organ to be involved by human immunodeficiency virus (HIV)-related malignancies. It is the second most common site for Kaposi sarcoma after skin, and the commonest visceral site, for Kaposi sarcoma in AIDS patients. GI lymphomas have been documented in approximately 25% of AIDS patients with systemic lymphomas. Moreover, GI involvement of AIDS-lymphoma has been associated with poor prognosis and short survival. Several other malignancies that occur in the GI tract are also closely related to HIV-infected or immunosuppressed individuals; these include posttransplant lymphoproliferative disorder, Epstein-Barr virus-associated smooth muscle tumors, anal precancerous lesions, and squamous cell carcinoma. As a result of active antiretroviral therapy, patients infected with HIV are living longer and are consequently at increased risk for development of cancer. Therefore, it is possible that the number of AIDS-associated malignancies will rise and the pattern of tumors may change in the future. In this paper, the clinicopathologic features of GI malignancies associated with AIDS patients are reviewed and the differential diagnosis with other mimic lesions is discussed.