A Case of Lipohyperplasia of the Stomach / 대한소화기내시경학회지

Lipohyperplasia is a lesion characterized by diffuse infiltration of lipocyte in the submucosal layer, which was formally known as 'lipomatosis' or 'lipomatous hyperplasia'. Lipohyperplasia is distinguished from lipoma, the former is not encapsulated and has normal mucosa. Most of lipohyperplasia developed at the ileocecal valve, showed clinical manifestation of abdominal pain, rectal bleeding, intestinal intussuception and intestinal obstruction. We experienced a case of a 45-year-old woman who had polypoid lipohyperplasia of the stomach. Her chief complaint was recurrent epigastric discomfort. Endoscopic finding was a 10 9 mm sized polypoid lesion in the anterior wall of lower body of the stomach. Endoscopic polypectomy was performed and the histological examination revealed infiltration of lipocyte in the submucosal layer.

A Case of Mixed Type Hemangioma of the Stomach with Upper Gastrointestinal Hemorrhage / 대한소화기내시경학회지

Hemangioma in the gastrointestinal tract rarely occurs especially in the stomach compared with the small and large intestine. A 45-year-old man was admitted with pneumonia. After hematemesis, the authors performed gastroscopy, which revealed active bleeding on the huge ulcer on the antrum of the stomach and multiple erosive lesions on the whole stomach. After multiple submucosal hypertonic saline injection and hemoclipping at the huge ulcerative lesion, ulcer bleeding stopped. Three days later, recurrent massive upper gastrointestinal bleeding occured at the same site of the stomach. To prevent futher recurrent bleeding, total gastrectomy with esophagojejunostomy and splenectomy was done. The histologic diagnosis of the ulcerative lesion was hemangioma of mixed type. We report this rare case with the brief literature review.

A case of aggressive angiomyxoma in female retroperitoneum / 대한내과학회지

Aggressive Angiomyxoma is a rare, benign but locally aggressive mesench ymal neoplasm, predominently involving the pelvis and perineum of young omen. We experienced a case of aggressive angiomyxoma in the retroperitoneum. A 47-year-old woman patient visited our hospital because of constipation and an abnormal intraabdominal mass in routine examination. Examination by abdominal ultrasonography and MR imaging indicated that it was a well capsulated large soft tissue tumor in the retroperitoneum. Thus, she underwent excision of the retroperitoneal tumor. A 15 x 10 x 2 cm yellow-whitish mass was noted. The cut surface was homogenous, tannish yellow and mucoid. Microscopic findings represent that a mass was composed of widely scattered spindle-shaped and stallate-shaped cells and variable sized vascular channels within a myxoid matrix. So we report this case with a review of literature.

A case of lipohyperplasia of the appendix / 대한내과학회지

Large intestinal Lipohyperplasia (LPH) is a poorly recognized lesion characterized by adipose tissue infiltration in the submucosal layer of the colon. Most of all, LPH developed at Ileoceal valve, especially upper lip which was called by ileocecal valve syndrome. For endoscopists and radiologists, it has often remained difficult to make a distinction from malignant neoplasia. We report here the case of a mild obese, 51-year-old man who had polypoid lipohyperplasia of the colon associated with extreme hyperplasia of the appendix. His chief complaint was recurrent intermittent abdominal pain. The colonoscopic finding was a submucosal tumor-like polypoid mass originating from appendix with smooth surface, But ileocecal valve was intact. Abdominal CT finding was 2.5 cm sized round heterogeneous low density mass like lesion with intratumoral fatty density of cecal tip area with enhancement of peripheral portion. In barium enema study, after retrograde filling of contrast, smooth extrinsic indentation of cecal tip with partial filling of appendix was seen. Histological exemination revealed infiltration of mature adipose tissue in the submucosal layer. Because of recurrent abdominal pain, ileocecal resection was performed at operation. We discuss the case and review the literatures on this subject.

A Case of Solitary Cecal Diverticulitis Misdiagnosed as a Cecal Tumor / 대한소화기내시경학회지

Cecal diverticulitis is a rare entity and remains a difficult diagnostic problem. Most patients are presented with an acute pain in the abdomen, which is nearly indistinguishable from that of appendicitis. Preoperative diagnostic studies are not helpful. Even with an operation, the correct diagnosis may be difficult to predict with certainty. The differential diagnosis between a cecal malignant tumor and a mass caused by inflammation due to cecal diverticulitis is difficult. Suspicion of a neoplastic process continues to prompt colectomy in an emergency setting. If diagnosed preoperatively, it can be treated effectively with a broad spectruum of antibiotics without surgical intervention. The physician must be aware this condition and be prepared to choose the most apropriate treatmetn. A case was experienced involving of solitary cecal diverticulitis misdiagnosed as a cecal tumor in a 61-year-o0ld female. This unique form of diverticulitis is herein reported with literature review.