Okano Soh, Yao Takashi, Nomura Osamu, Nagahara Akihito, Hagiwara Toshiaki, Sugimoto Kiichi, Takahashi Makoto, Sakamoto Kazuhiro
Department of Human Pathology, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan.
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan.
Case Rep Pathol. 2022 Mar 7;2022:5120607. doi: 10.1155/2022/5120607. eCollection 2022.
Enterocolic lymphocytic phlebitis is phlebitis of unknown etiology in which lymphocytes affect veins without arteries and shows evidence of systemic vasculitis in the intestinal wall and mesentery, mainly in the small intestine and colon. Although patients present with a variety of gastrointestinal symptoms and findings like those of inflammatory bowel disease or ischemic bowel disease, there are no specific findings for enterocolic lymphocytic phlebitis. As a result, a diagnosis tends to be made after surgery. There are few case reports of enterocolic lymphocytic phlebitis, and the impact of chronic courses and immunosuppressive drugs on enterocolic lymphocytic phlebitis is not well known. A 47-year-old man was treated with infliximab and steroids for unexplained ulceration and narrowing of the ileocecal area, which was suspected to be inflammatory bowel disease with atypical findings. Lymphocytic phlebitis was noted in the surgical specimen, and enterocolic lymphocytic phlebitis was diagnosed. No recurrence of enterocolic lymphocytic phlebitis was observed postoperatively. This disease should also be considered among patients with inflammatory bowel disease-like lesions that do not respond to infliximab or steroids.
小肠结肠淋巴细胞性静脉炎是一种病因不明的静脉炎,其中淋巴细胞累及静脉而不累及动脉,并在肠壁和肠系膜(主要是小肠和结肠)呈现系统性血管炎的证据。尽管患者表现出多种胃肠道症状和体征,与炎症性肠病或缺血性肠病相似,但小肠结肠淋巴细胞性静脉炎并无特异性表现。因此,诊断往往在手术后才能做出。小肠结肠淋巴细胞性静脉炎的病例报告较少,慢性病程和免疫抑制药物对小肠结肠淋巴细胞性静脉炎的影响尚不清楚。一名47岁男性因回盲部不明原因的溃疡和狭窄接受英夫利昔单抗和类固醇治疗,怀疑是非典型表现的炎症性肠病。手术标本中发现淋巴细胞性静脉炎,诊断为小肠结肠淋巴细胞性静脉炎。术后未观察到小肠结肠淋巴细胞性静脉炎复发。对于对英夫利昔单抗或类固醇无反应的炎症性肠病样病变患者,也应考虑本病。