Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain.
Pathol Res Pract. 2012 Nov 15;208(11):687-90. doi: 10.1016/j.prp.2012.08.010. Epub 2012 Oct 2.
Pyogenic granuloma (PG) is a polypoid lobular capillary hemangioma rarely described in the large bowel. We describe the case of a 72-year-old man with recent weight loss, anemia, and change in bowel habit. A 3cm×2cm polypoid lesion in the right flexure of the colon was observed and treated with extended right hemicolectomy. A review of the English-language literature on PG of the large bowel in adults yielded eight previously reported cases. The age of the patients ranged from 26 to 80 years with a mean of 54.8 years. The lesions were all solitary, except one case of multiple lesions in the colon. Another case was associated with satellite lesions. Seven cases were located in the colon and two in the rectum. The mean maximum diameter of the lesions was 1.6cm (range 0.5-3cm). Colorectal bleeding was the most common clinical symptom. Due to its unusual appearance, PG can be misdiagnosed and mistreated as colon carcinoma with extensive surgery. Polypectomy or endoscopy mucosal resection is the optimal treatment. In large or deep lesions, a surgical excision may be necessary. Pathologists should be familiar with this condition so as to avoid overdiagnosis as a malignant vascular tumor.
化脓性肉芽肿（PG）是一种罕见于大肠的息肉样小叶毛细血管血管瘤。我们描述了一例 72 岁男性，近期体重减轻、贫血和排便习惯改变。在结肠右曲处观察到一个 3cm×2cm 的息肉样病变，并进行了扩大右半结肠切除术。对英文文献中关于成人大肠 PG 的回顾性研究共发现了 8 例先前报道的病例。患者年龄从 26 岁到 80 岁不等，平均年龄为 54.8 岁。病变均为单发，除一例结肠多发病变外。另一个病例伴有卫星病变。7 例位于结肠，2 例位于直肠。病变的最大直径平均为 1.6cm（范围 0.5-3cm）。结直肠出血是最常见的临床症状。由于其不常见的外观，PG 可能被误诊和过度治疗为结肠癌，并进行广泛的手术。息肉切除术或内镜黏膜切除术是最佳治疗方法。对于大或深的病变，可能需要手术切除。病理学家应熟悉这种情况，以免过度诊断为恶性血管肿瘤。
