Small bowel (small intestine) - Pneumatosis cystoides intestinalis

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Small bowel (small intestine)

Benign tumors and tumor-like conditions

Pneumatosis cystoides intestinalis

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 22 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Submucosal gas-filled cysts in GI tract
● Called mucosal pseudolipomatosis if it resembles lipomatosis

Clinical features
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● Part of differential diagnosis of acute abdomen (World J Gastroenterol 2012;18:453)
● In infants, associated with necrotizing enterocolitis and may be fatal; also associated with cystic fibrosis, congenital heart defects
● In adults, either idiopathic or varied clinical settings including chemotherapy, chronic lung disease, drugs, ischemic colitis, obstruction, scleroderma (World J Gastroenterol 2011;17:4932, Arch Pathol Lab Med 2010;134:378)
● Often indolent clinical course, although radiographically resembles carcinoma
● Considered a finding, not a diagnosis

Case reports
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● 6 year old girl with ulcerative colitis (Arch Pathol Lab Med 1999;123:354)
● 73 year old woman with dysplasia in perforated intestinal pneumatosis (World J Gastroenterol 2009;15:4189)
● Idiopathic myointimal hyperplasia of mesenteric veins and pneumatosis intestinalis (J Crohns Colitis 2011;5:239)

Gross description
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● Polypoid grapelike masses protrude through mucosa
● Soft, bluish, and often sessile,‘‘bubble wrap’’ crackling noise while handling the specimen

Clinical images
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Endoscopy

Gross images
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Various images

Micro description
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● Submucosal cysts lined by multinucleated giant cells
● Mucosa contains cryptitis, crypt abscesses, granulomas
● May also resemble lipomatosis

Micro images
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Various images

Differential diagnosis
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● Crohn’s disease

End of Small bowel (small intestine) > Benign tumors and tumor-like conditions > Pneumatosis cystoides intestinalis

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