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

Meeks, Marshall W.; Kamal, Umar M; Hammami, Muhammad B.; Taylor, Jason R.; Chen, Yongxin; Lai, Jinping

doi:10.1155/2016/4398401

Cited by 11 publications

(17 citation statements)

References 49 publications

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“…There are approximately 50 cases of GI PG in the English literature (13). The endoscopic appearance of PG lesions is usually a smooth and ulcerated surface that appears friable.…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of treatment modality, recurrence is rare. Length of follow-up after PG resection was recorded for 19 patients, and only 2 (11%) of these patients had recurrence after resection (13,(16)(17). However, the median follow-up in these studies was only 8 months (range=1-39 months).…”

Section: Figure 2 Immunohistochemistry A-b: CMV Immunoreactivity Prmentioning

confidence: 94%

“…Only 8 lesions (22%) were larger than 20 mm. PG typically only involves the mucosa but can extend into the submucosa and even the full thickness of the luminal wall (13). Histologically, PG is an exophytic, often ulcerated lesion characterized by lobulated proliferation of capillaryresembling vessels in a loose and edematous stroma.…”

Section: Figure 2 Immunohistochemistry A-b: CMV Immunoreactivity Prmentioning

confidence: 99%

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Small Bowel Pyogenic Granuloma With Cytomegalovirus Infection in a Patient With Crohn's Disease (Report of a Case and Review of the Literature)

Zhang

Glover

Liu

et al. 2018

In Vivo

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Pyogenic granuloma (PG) represents a lobular capillary proliferation commonly seen in the skin or oral mucosa. They are rarely reported in the gastrointestinal tract. The mechanism underlying PG pathogenesis is not well understood. Only one case of cutaneous PG associated with cytomegalovirus (CMV) infection has been reported in the English literature. Here, we report such a unique case of PG arising from the small bowel. A 67-year-old male, status post ileocolic resection, presented for follow-up colonoscopy because of Crohn's disease of the terminal ileum and the colon. Colonoscopy revealed inflammation at the ileocolic anastomosis as well as an 8-mm pedunculated lesion with an irregular surface in the neo-terminal ileum. Histological studies of the small bowel mucosa revealed chronic active ileitis with pyloric gland metaplasia, consistent with his clinical history of Crohn's disease. The lesion demonstrated a lobular architecture consisting of clusters of small capillaries of various sizes lined by a single layer of cytologically bland endothelial cells, and accompanied by acute and chronic inflammatory infiltrates and surface erosion/ulceration. The histological features supported the diagnosis of PG. Scattered viral inclusions with positive CMV immunoreactivity were present in the endothelial cells and glandular cells of pyloric gland metaplasia within the PG. To the best of our knowledge, this is the first documented case of PG with local CMV infection in patients with inflammatory bowel disease.

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“…There are approximately 50 cases of GI PG in the English literature (13). The endoscopic appearance of PG lesions is usually a smooth and ulcerated surface that appears friable.…”

Section: Discussionmentioning

confidence: 99%

Section: Figure 2 Immunohistochemistry A-b: CMV Immunoreactivity Prmentioning

confidence: 94%

Section: Figure 2 Immunohistochemistry A-b: CMV Immunoreactivity Prmentioning

confidence: 99%

See 1 more Smart Citation

Small Bowel Pyogenic Granuloma With Cytomegalovirus Infection in a Patient With Crohn's Disease (Report of a Case and Review of the Literature)

Zhang

Glover

Liu

et al. 2018

In Vivo

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“…1-3 Microscopically, this tumor is composed of small blood vessels growing in an unique lobular architecture and can be misdiagnosed as a malignant vascular tumor. 1,2 PG in the gastrointestinal tract is extremely rare, 2-5 and only few PGs arising from the esophagus have been previously described in the English literature. 2,3,6-15 In this article, we report a rare case of an esophageal PG with a review of previously reported cases.…”

Section: Introductionmentioning

confidence: 99%

Esophageal Pyogenic Granuloma: A Case Report and Review of the Literature

et al. 2018

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Pyogenic granuloma (PG) is a capillary hemangioma mainly found in the skin and oral mucosa, but rarely described in the esophagus. We report the case of a 66-year-old man who consulted for retrosternal pain. Endoscopic studies showed a 28-mm polypoid mass located at the distal esophageal mucosa. The patient underwent endoscopic resection, and the histopathological examination showed a neoplastic proliferation of small blood vessels growing in a lobular architecture, with edematous stroma and prominent inflammatory infiltrate. Special stains for fungus showed pseudohyphae compatible with Candida spp. Findings were consistent with those of an esophageal PG associated with Candida infection. This case is a reminder that PG can be found in the esophagus, can be associated with other entities such as Candida infection, and is one of the differential diagnoses of neoplastic vascular proliferations that may mimic malignancy. In addition, we reviewed previously reported cases of esophageal PG.

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“…Histology analysis revealed an 8 × 6 × 5 mm lobular capillary hemangioma with erosion on the mucosal surface. Also known as pyogenic granuloma, lobular capillary hemangiomas are most common in nasal mucosa and skin [1], and are very rare in the small and large intestine [2]. The typical presentation is gastrointestinal bleeding with or without anemia or abdominal pain.…”

mentioning

confidence: 99%