IBB CNR, Naples, Via Pansini 5, 80131, Naples, Italy.
World J Gastroenterol. 2010 May 28;16(20):2566-70. doi: 10.3748/wjg.v16.i20.2566.
The involvement of the small bowel in systemic forms of amyloidosis may be diffuse or very rarely focal. Some cases of focal amyloidomas of the duodenum and jejunum without extraintestinal manifestations have been reported. The focal amyloidomas consisted of extensive amyloid infiltration of the entire intestinal wall thickness. Radiological barium studies, ultrasound and computed tomography (CT) patterns of diffuse small bowel amyloidosis have been described: the signs are non-specific and may include small-bowel dilatation, symmetric bowel wall thickening, mesenteric infiltration, and mesenteric adenopathy. No data are available about the positron emission tomography (PET)/CT and magnetic resonance imaging (MRI) patterns of intestinal amyloidosis. We report two cases of small bowel amyloidosis: the former characterized by focal deposition of amyloid proteins exclusively within blood vessel walls of the terminal ileum, the latter characterized by diffuse intestinal involvement observed on MRI and PET/CT studies.
累及小肠的系统性淀粉样变可能为弥漫性或非常罕见的局灶性。有报道称,十二指肠和空肠局灶性淀粉样瘤而无肠外表现的病例。局灶性淀粉样瘤由整个肠壁厚度的广泛淀粉样浸润组成。弥漫性小肠淀粉样变性的放射学钡剂研究、超声和计算机断层扫描(CT)模式已有描述:这些征象是非特异性的,可能包括小肠扩张、肠壁对称性增厚、肠系膜浸润和肠系膜淋巴结病。关于正电子发射断层扫描(PET)/CT 和磁共振成像(MRI)的肠淀粉样变性的资料尚不清楚。我们报告两例小肠淀粉样变性:前者的特征是在回肠末端的小血管壁中仅存在淀粉样蛋白的局灶性沉积,后者的特征是在 MRI 和 PET/CT 研究中观察到的弥漫性肠累及。