Colonic pseudolipomatosis, microscopically classified into two groups

Colonic Pseudolipomatosis: A Spectrum of Two Illustrated Cases of an Uncommon Condition

Colonic pseudolipomatosis (CP) is a rare, benign condition typically identified incidentally during routine colonoscopies. Characterized by gas-filled vacuoles within the colonic mucosa, CP is often asymptomatic and self-limiting but can be misinterpreted as more serious conditions, such as ischemic colitis or pseudomembranous colitis. We report two cases of CP with distinct clinical presentations: a 55-year-old asymptomatic male patient with an incidental lesion found during routine screening and a 73-year-old male who developed lower gastrointestinal bleeding 10 days after an extended colonoscopy with multiple polypectomies. Histopathological analysis confirmed CP in both cases. The first patient required no further intervention, while the second underwent supportive care and a follow-up colonoscopy, which showed resolution of the lesions. These cases highlight the spectrum of CP, emphasizing the importance of recognizing this entity to avoid misdiagnosis and unnecessary interventions. Furthermore, they underscore the role of careful endoscopic techniques and disinfection protocols in minimizing the occurrence of iatrogenic CP.

Endoscope disinfectant-induced colonic pseudolipomatosis: case series of a rare condition

Aim: Colonic mucosal pseudolipomatosis is a rare and benign endoscopic finding with distinct macroscopic and histological characteristics. Case series: We observed a form of unprecedented colitis in eight patients in a 3-month period. Operators have found, during colonoscopy, flat or slightly raised whitish-yellow plaques, in the colonic mucosa of all patients. Histological examination concluded to pseudolipomatosis. After investigation, the disinfectant machine was found to have technical malfunctioning of the rinse cycle of the endoscope during this period. No other cases were observed after the machine was fixed. Conclusion: Pseudolipomatosis is more an endoscopically induced lesion than a true pathological condition. A careful check of the disinfection process should be carried out when such lesions are detected.

Unusual mucosal lesion: A case of rectal pseudolipomatosis in a 60-year-old patient

Pseudolipomatosis is a very rare benign pathologic condition of colorectal mucosa. It is caused by the presence of gas bubbles in the intestinal mucosa. The endoscopic and histologic aspects are misleading as they suggest adipocytic or vascular lesions. We present herein a case of rectal pseudolipomatosis in a 60-year-old woman presenting with rectal bleeding. The endoscopic pattern was not suggestive of the lesion, and the histopathologic analysis of the patient’s rectal biopsies revealed characteristic features of pseudolipomatosis. Rectocolic pseudolipomatosis is a very rare benign condition with challenging clinicopathologic presentation. Clinicians and pathologists should be aware of this uncommon lesion for correct diagnosis and appropriate clinical management.

Pseudolipomatosis affects specimens from endometrial biopsies

Pseudolipomatosis refers to optically clear vacuoles that artifactually contaminate specimens, and it most commonly affects the gastrointestinal tract. Pseudolipomatosis closely resembles adult white fat and is of group "A" or "B" when vacuoles have mild or marked variation in size, respectively. Pseudolipomatosis has yet to be reported to occur in the endometrium. Pseudolipomatosis in the endometrium might be easily mistaken for extrauterine adipocytes and misdiagnosed as perforation. We retrospectively reviewed 50 consecutive specimens from endometrial biopsies to determine the prevalence of endometrial pseudolipomatosis and whether pseudolipomatosis was related to perforation. All 50 specimens contained pseudolipomatosis of group "B," and lacked extrauterine tissue. To our knowledge, all patients lacked clinical evidence of perforation at follow-up. Pseudolipomatosis commonly affects specimens from endometrial biopsies and is likely unrelated to perforation. Awareness of pseudolipomatosis is necessary to avoid misdiagnosing uterine perforation.