Javadi Arezoo Eftekhar, Nazar Elham, Momeni Niousha
Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Iran.
Ann Med Surg (Lond). 2022 Jul 13;80:104196. doi: 10.1016/j.amsu.2022.104196. eCollection 2022 Aug.
Systemic mastocytosis is a rare disease resulting from infiltration of atypical mast cells in multiple organ systems and present with variety of symptoms. Primary appendiceal and cecal mass with isolated abdominal pain as a presenting feature in systemic mastocytosis have not been reported in literature up to now.
We described a 69- years-old female with systemic mastocytosis who presented with chronic abdominal pain and recent progression. On imaging of the abdomen and pelvis showed a mass in cecum. The patient underwent surgery and histopathologic evaluation of cecal and appendiceal masses revealed uniform small round cell tumor with eosinophilic cytoplasm admixed with many eosinophils distorting normal colonic mucosal architecture. The neoplastic cells showed positive expression of CD117 and Mast cell tryptase. According to all these considerations systemic mastocytosis was confirmed as the diagnosis.
Isolated abdominal pain and primary large intestinal mass are uncommon features of systemic mastocytosis. This case report informed physicians and pathologists to consider it as one of differential diagnosis.
系统性肥大细胞增多症是一种罕见疾病,由非典型肥大细胞浸润多个器官系统引起,并伴有多种症状。迄今为止,文献中尚未报道以孤立性腹痛为主要表现的原发性阑尾和盲肠肿块的系统性肥大细胞增多症。
我们描述了一名69岁患有系统性肥大细胞增多症的女性,她表现为慢性腹痛且近期病情进展。腹部和骨盆影像学检查显示盲肠有一个肿块。患者接受了手术,对盲肠和阑尾肿块的组织病理学评估显示为均匀的小圆形细胞瘤,伴有嗜酸性细胞质,混有许多嗜酸性粒细胞,扭曲了正常结肠黏膜结构。肿瘤细胞显示CD117和肥大细胞类胰蛋白酶呈阳性表达。综合所有这些因素,确诊为系统性肥大细胞增多症。
孤立性腹痛和原发性大肠肿块是系统性肥大细胞增多症的不常见特征。本病例报告提醒医生和病理学家将其作为鉴别诊断之一。