Nonose Ronaldo, Priolli Denise Gonçalves, Cardinalli Izilda Aparecida, Máximo Felipe Rodrigues, Galvão Patrícia Savói Pires, Martinez Carlos Augusto Real
Postgraduate Health Sciences Program, Universidade São Francisco, Bragança Paulista, São Paulo, Brazil.
Sao Paulo Med J. 2008 Sep;126(5):294-6. doi: 10.1590/s1516-31802008000500011.
Epithelioid hemangioma or angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular neoplasm that is usually located on the face or neck. Exceptionally, it has been described affecting the colon, with only two such cases described in the worldwide literature. The aim here was to present a case of primary epithelioid hemangioma of the sigmoid colon with confirmation by immunohistochemical examination.
A 37-year-old woman had had a complaint of intermittent abdominal pain for six months. Two months after the condition started, she began to present changes in her intestinal habit, with evacuations containing blood and mucus and a weight loss of 4 kg over this period. At physical examination, a palpable mass was noted in the lower left quadrant of the abdomen. Neoplasia of the colon was clinically suspected and she underwent colonoscopy. This demonstrated the presence of a vegetating sessile lesion of approximately 5 cm in diameter, at a distance of 36 cm from the anal margin. It occupied 80% of the intestinal lumen. A biopsy collected during the examination suggested a diagnosis of neoplasia of vascular origin. After surgical resection, histopathological examination of the resected specimen confirmed the diagnosis of epithelioid hemangioma of the colon, which was backed up by the immunohistochemical panel (factor VIII, Ki-67, CD-34). At present, three years after the surgery, the patient is asymptomatic, she has recovered her normal weight and she has normal findings from control colonoscopy. Despite the rarity of neoplasia of vascular origin, this possibility should be considered in the differential diagnosis for colorectal tumors.
上皮样血管瘤或伴有嗜酸性粒细胞增多的血管淋巴样增生是一种罕见的良性血管肿瘤，通常位于面部或颈部。极个别情况下，有报道称其可累及结肠，全球文献中仅描述了两例此类病例。本文旨在报告一例经免疫组化检查确诊的乙状结肠原发性上皮样血管瘤病例。
一名37岁女性有六个月间歇性腹痛的主诉。病情开始两个月后，她开始出现肠道习惯改变，大便带血和黏液，在此期间体重减轻了4千克。体格检查时，在左下腹可触及一个肿块。临床上怀疑结肠肿瘤，她接受了结肠镜检查。检查发现距肛缘36厘米处有一个直径约5厘米的带蒂息肉样病变，占据肠腔的80%。检查期间采集的活检组织提示血管源性肿瘤的诊断。手术切除后，对切除标本的组织病理学检查证实为结肠上皮样血管瘤，免疫组化结果（因子VIII、Ki-67、CD-34）支持这一诊断。目前，手术后三年，患者无症状，体重恢复正常，结肠镜复查结果正常。尽管血管源性肿瘤罕见，但在结直肠肿瘤的鉴别诊断中应考虑到这种可能性。
