Journal of Pathology and Translational Medicine

Case Reports

Multiple Jejunal Myeloid Sarcomas Presenting with Intestinal Obstruction in a Non-leukemic Patient: A Case Report with Ultrastructural Observations: Na Rae Kim, Woon Kee Lee, Jong In Lee, Hyun Yee Cho; Korean J Pathol. 2012;46(6):590-594. Published online December 26, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.590

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Myeloid sarcoma is a rare extramedullary myeloid tumor, which is frequently misdiagnosed when no evidence of leukemia is initially observed. Here, we report on a peculiar case of a 49-year-old man afflicted with multiple masses in the jejunum, the superior mesentery, and the serosa of the transverse colon, without leukemic manifestation. The tumor was composed of undifferentiated small round cells containing eosinophilic cytoplasm, which were negative for myeloperoxidase, nonspecific esterase, lysozyme, terminal deoxynucleotidyl transferase, leukocyte common antigen, CD3, CD4, CD15, CD20, CD30, CD43, CD56, CD68/PG-M1, CD79a, human melanoma black-45, c-kit, and CD34 with positivity only for CD68/KP1, CD99, and vimentin. Under electron microscopy, those cells had abundant membrane-bound cytoplasmic granules that measured 200 to 300 nm in diameter, which were consistent with granulocytic azurophilic granules. The tumor was finally diagnosed as a myeloid sarcoma. The presence of non-leukemic myeloid sarcomas showing immunonegativity for conventional myeloid-leukemic markers necessitated a diagnosis by ultrastructural observation.

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Primary ileal myeloid sarcoma presenting with bowel obstruction: a case report
Hitoshi Minagi, Nobuhiko Kanaya, Yoshitaka Kondo, Yoshihiko Kakiuchi, Shinji Kuroda, Ryohei Shoji, Hajime Kashima, Yuki Matsumi, Satoru Kikuchi, Kunitoshi Shigeyasu, Fuminori Teraishi, Shunsuke Kagawa, Toshiyoshi Fujiwara
Surgical Case Reports.2024;[Epub] CrossRef
Isolated myeloid sarcoma presenting with small bowel obstruction: a case report
Rie Mizumoto, Masanori Tsujie, Tomoko Wakasa, Kotaro Kitani, Hironobu Manabe, Shuichi Fukuda, Kaoru Okada, Shumpei Satoi, Hajime Ishikawa, Toshihiko Kawasaki, Hitoshi Hanamoto, Masao Yukawa, Masatoshi Inoue
Surgical Case Reports.2020;[Epub] CrossRef
Primary Myeloid Sarcoma of the Ileum and Mesentery Causing Small Bowel Obstruction: Case Report and Literature Review
Andrej Nikolovski, Dragoslav Mladenovikj, Aleksandra Veljanovska, Gordana Petrusevka
Lietuvos chirurgija.2020; 19(1-2): 55. CrossRef
Utility of Transmission Electron Microscopy in Small Round Cell Tumors
Na Rae Kim, Seung Yeon Ha, Hyun Yee Cho
Journal of Pathology and Translational Medicine.2015; 49(2): 93. CrossRef

Adenocarcinoma with Intraductal Papillary Mucinous Neoplasm Arising in Jejunal Heterotopic Pancreas: Ju Young Song, Jee Young Han, Sun Keun Choi, Lucia Kim, Suk Jin Choi, In Suh Park, Young Chae Chu, Kyu Ho Kim, Joon Mee Kim; Korean J Pathol. 2012;46(1):96-100. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.96

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Abstract PDF

A 74-year-old man suffered from jejunal perforation and adhesion to sigmoid colon due to adenocarcinoma associated with intraductal papillary mucinous neoplasm (IPMN) arising in a jejunal heterotopic pancreas. The jejunal lesion showed direct extension to the sigmoid colon, which was mistaken as sigmoid colon cancer by surgeons. Malignant transformation is a rare complication of a heterotopic pancreas. About half of malignancies in reported cases were ductal adenocarcinoma arising in the stomach, and the jejunal location is extremely rare. Furthermore, IPMN is also uncommon finding in a heterotopic pancreas.

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Intraductal Papillary Mucinous Neoplasm Arising from Heterotopic Pancreas in Stomach: A Case Report and Review of Literature
Yu Pang, Yuyu Liu, Qinqin Liu, Gang Hou
International Journal of Surgical Pathology.2023; 31(5): 708. CrossRef
Clinicopathological features of intraductal papillary mucinous neoplasm derived from ectopic pancreas: A systematic review
Jiro Kimura, Takehiro Okabayashi, Kenta Sui, Takahiro Murokawa, Motoyasu Tabuchi, Masaki Aida, Jun Iwata, Yasuhiro Hata
Surgery Open Science.2022; 8: 62. CrossRef
Clinicopathological Features of Intraductal Papillary Mucinous Neoplasm Derived from Ectopic Pancreas: A Systematic Review
Jiro Kimura, Takehiro Okabayashi, Kenta Sui, Takahiro Murokawa, Motoyasu Tabuchi, Masaki Aida, Jun Iwata, Yasuhiro Hata
SSRN Electronic Journal .2022;[Epub] CrossRef
A case of ectopic pancreas of the stomach accompanied by intraductal papillary mucinous neoplasm with GNAS mutation
Naoko Nambu, Takashi Yamasaki, Nami Nakagomi, Tsutomu Kumamoto, Tatsuro Nakamura, Akio Tamura, Toshihiko Tomita, Hiroto Miwa, Hisashi Shinohara, Seiichi Hirota
World Journal of Surgical Oncology.2021;[Epub] CrossRef
Intraductal Papillary Mucinous Neoplasm Arising in a Heterotopic Pancreas Treated by Percutaneous Endoscopic Intragastric Surgery
Shoko Moue, Yoshimasa Akashi, Koichi Ogawa, Katsuji Hisakura, Tsuyoshi Enomoto, Yusuke Ohara, Yohei Owada, Shingo Sakashita, Tatsuya Oda
The Japanese Journal of Gastroenterological Surgery.2020; 53(4): 371. CrossRef
Adenocarcinoma with intraductal papillary mucinous neoplasm arising in a duodenal heterotopic pancreas: a case report
Etsuko Hisanaga, Takaaki Sano, Norio Kubo, Norihiro Ishii, Ken Shirabe, Hitoshi Takagi, Junko Hirato, Hayato Ikota
Clinical Journal of Gastroenterology.2020; 13(6): 1373. CrossRef
Malignant Transformation of Ectopic Pancreas
Irina M. Cazacu, Adriana Alexandra Luzuriaga Chavez, Graciela M. Nogueras Gonzalez, Adrian Saftoiu, Manoop S. Bhutani
Digestive Diseases and Sciences.2019; 64(3): 655. CrossRef
Anomalien im pankreatikobiliären System
Dirk Walter, Michael Jung
Der Gastroenterologe.2019; 14(4): 301. CrossRef
Intraductal papillary mucinous neoplasm originating from a heterotopic pancreas within the jejunum: a case report
Eiji Noda, Kenji Kuroda, Tomohisa Sera, Takuya Mori, Haruhito Kinoshita, Tsuyoshi Hasegawa, Hitoshi Teraoka, Takaaki Chikugo
Journal of Surgical Case Reports.2018;[Epub] CrossRef
Heterotopic Pancreas of the Gastrointestinal Tract and Associated Precursor and Cancerous Lesions
Sun-Young Jun, Dahye Son, Mi-Ju Kim, Sung Joo Kim, Soyeon An, Young Soo Park, Sook Ryun Park, Kee Don Choi, Hwoon-Yong Jung, Song Cheol Kim, Jeong Hwan Yook, Byung-Sik Kim, Seung-Mo Hong
American Journal of Surgical Pathology.2017; 41(6): 833. CrossRef
Heterotopic Pancreas within the Proximal Hepatic Duct, Containing Intraductal Papillary Mucinous Neoplasm
Alistair J. Lawrence, Aducio Thiessen, Amy Morse, A. M. James Shapiro
Case Reports in Surgery.2015; 2015: 1. CrossRef
Bowel Rest
Payal Saxena, Deborah Belchis, Anne Marie Lennon
Clinical Gastroenterology and Hepatology.2015; 13(13): e173. CrossRef
Adenocarcinoma arising from jejunal ectopic pancreas mimicking peritoneal metastasis from colon cancer: a case report and literature review
Yusuke Yamaoka, Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Masakatsu Numata, Shinya Sugimoto, Kenichiro Imai, Kinichi Hotta, Keiko Sasaki
Surgical Case Reports.2015;[Epub] CrossRef
Intraductal papillary mucinous neoplasm of the ileal heterotopic pancreas in a patient with hereditary non-polyposis colorectal cancer: A case report
Sang Hwa Lee
World Journal of Gastroenterology.2015; 21(25): 7916. CrossRef

Primary Adenosquamous Carcinoma of Jejunum.: Soon Ran Kim, Jung Weon Shim, Hye Kyung Ahn, Young Euy Park, Dae Gi Song, Young Cheol Lee, Myung Seuk Lee; Korean J Pathol. 1997;31(2):182-184.

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Abstract PDF: Adenosquamous carcinomas of the intestine are rare tumors, especially when they occur in the small bowel. We report a case of primary adenosquamous carcinoma of the proximal jejunum in a 66 year old woman with no underlying pathologic condition. The tumor mainly consisted of well differentiated squamous cell carcinoma showing keratin pearl and conspicuous intercellular bridges, and minor portion revealed well differentiated adenocarcinoma. The tumor seemed to have originated from the mucosal epithelium, invading the entire wall and metastasizing to the regional lymph nodes. Previous reports of adenosquamous carcinoma of the small intestine have been associated with metastatic disease from distant sites or intestinal duplication. In the colon, squamous cell differentiation have been seen in about 0.05% of adenocarcinomas and in 0.4% of adenomata. The pathogenesis of squamous cell carcinoma of the intestine is unknown, but some possible mechanisms are proposed. :1)malignant transformation of squamous cell epithelium in the submucosa, 2)aberrant differentiation of stem cells to squamous cell with subsequent malignant change, 3)squamous metaplasia of glandular cells with subsequent malignant change, 4)transformation of an adenosquamous into an epidermoid carcinoma.

Angiodysplasia Arising in the Bowels: Two cases report.: Soo Kee Min, Hee Jeung Cha, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 1997;31(12):1308-1313.

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Abstract PDF: Gastrointestinal angiodysplasia is a distinct disease entity which causes frequent gastrointestinal bleeding. It predominantly arises at the stomach and duodenum in the upper gastrointestinal tract and cecum and ascending colon in the lower gastrointestinal tract. The general histological finding of the angiodysplasia is a submucosal vascular ectasia and tortuosity. We have experienced two cases of the intestinal angiodysplasia. The first case occurred on a jejunum in a 22-year-old woman who had anemia. The second case occurred on a sigmoid colon in a 59-year-old man who had constipation. In addition to the general histologic finding of the angiodysplasia, the microscopic findings of the first case revealed some capillary hemangioma-like areas; and in the second case, there was a marked ischemic change and the thickening of the wall.

Synchronous Development of Gastrointestinal Stromal Tumor and Arteriovenous Malformation in the Jejunum: A Case Report.: Sang Hwa Shim, Yoon Hee Han, Ji Eun Kwak, Sun Hee Chang, Hanseong Kim, Je G Chi, Mee Joo; Korean J Pathol. 2008;42(3):185-188.

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Abstract PDF: Vascular malformations associated with neoplasms are extremely rare. Herein we report an extraordinary coincidence of arteriovenous malformation (AVM) and gastrointestinal stromal tumor (GIST) in the jejunum. A 44-year-old woman presented with melena and anemia. Abdominal computed tomography revealed a highly vascularized, strong early arterial enhancing soft tissue mass in the jejunum, which was confirmed by angiography to be an AVM supplied by the distal jejunal branch of the superior mesenteric artery. An emergency operation was performed due to active gastrointestinal (GI) bleeding. The resected jejunum showed a protruding, mostly solid subserosal mass. The mass was confirmed to be a spindle cell type GIST and was intermingled with the AVM located in the overlying submucosa and muscularis propria. To our knowledge, this is the first reported case of an AVM associated with a GIST. This case masqueraded radiologically as an AVM alone and presented clinically with GI bleeding.

Angiosarcoma of Jejunum Following Therapeutic Irradiation: A case report.: Mee Hye Oh, So Young Park, Yeon Lim Suh; Korean J Pathol. 1993;27(3):268-273.

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Abstract PDF: We report a case of angiosarcoma of the jejunum in a 65-year-old female. This angiosarcoma developed 20 years after postoperative irradiation for cervical carcinoma of the uterus. Grossly, the resected jejunum showed a 8 cm long segmental hemorrhagic lesion with multiple, small hemorrhagic nodules or cysts on its serosa and mesentery. Microscopically, the wall of jejunum was infiltrated by epithelioid or polygonal tumor cells arranged in solid nests or lining irregular vascular spaces. The case is of interest that the tumor occurred in the very unusal site for angiosarcoma and the patient had a past history of irradiation for uterine cervical carcinoma 20 years ago. In addition, the resected intestine showed histologic changes of chronic irradiation effect. Therefore, this case supports the view that there is cause and effect relationship between irradiation adn angiosarcoma.

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