A Case of Xanthogranulomatous Inflammation of Terminal Ileum Presenting as a Mass in a Woman with Severe Obesity.
10.4166/kjg.2016.67.5.277
- Author:
Hyung Ku CHON
1
;
Sang Wook KIM
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea. clickm@jbnu.ac.kr
- Publication Type:Case Report
- Keywords:
Xanthogranulomatous;
Morbid obesity;
Ileum
- MeSH:
Abdominal Pain;
Adult;
Cholecystitis;
Diagnosis, Differential;
Female;
Giant Cells;
Histiocytes;
Humans;
Ileum*;
Inflammation*;
Obesity;
Obesity, Morbid*;
Pyelonephritis;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2016;67(5):277-281
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Xanthogranulomatous inflammation is an acute or chronic inflammatory condition most frequently reported in pyelonephritis and cholecystitis. However, the involvement of the terminal ileum is extremely rare. Its clinical significance is that it can mimic a malignant lesion clinically and intraoperatively, as well as radiographically. A 34-year-old European ethnic female presented with gradually aggravated abdominal pain in right lower quadrant for 15 days. There was no significant medical, surgical or traumatic history, except class III obesity (BMI, 41.0 kg/m2). An abdominal CT showed about a 4.7×3.7 cm sized, mass-like lesion in the terminal ileum. Despite symptomatic treatment, her clinical symptoms did not improve. After six days, she underwent a laparoscopic ileocecectomy. Pathologic findings showed extensive inflammation with occasional multinucleated giant cells and aggregates of foamy histiocytes, consistent with xanthogranulomatous inflammation. Here, we present a case of xanthogranulomatous inflammation in the terminal ileum presenting as subacute abdominal pain and a mass on imaging study. Xanthogranulomatous inflammation should be added to the differential diagnosis of patients with a suspected mass-like lesion in the terminal ileum.
