Department of Surgery, Faculdade de Medicina de Sorocaba (FCMS-PUCSP), São Paulo, Brazil.
Hospital Moriah, São Paulo, Brazil.
J Med Case Rep. 2024 Sep 19;18(1):437. doi: 10.1186/s13256-024-04766-y.
The aim of this case report is describe an unprecedented case with histological and immunohistochemical diagnosis of splenic heterotopy in the colon using material obtained by endoscopic ultrasound-guided biopsy.
Splenic heterotopia is a benign condition characterized by the implantation of splenic tissue in areas distant from its usual anatomical site, such as the peritoneum, omentum, mesentery, liver, pancreas, and subcutaneous tissue and, more rarely, in locations such as the colon and brain. It is generally associated with a history of splenic trauma or splenectomy and typically does not cause specific symptoms.
A 35-year-old white male patient who was healthy, with no history of trauma or splenectomy, but had a family history of colorectal neoplasia underwent colonoscopy for screening. The examination revealed a large bulge in the proximal descending colon, covered by normal-appearing mucosa. Endoscopic ultrasound-guided puncture was performed with a 22 gauge fine needle biopsy, and the histopathological and immunohistochemical analysis results were consistent with a heterotopic spleen.
This is the first report of a primary intramural colic splenosis case with histological and immunohistochemical diagnosis of splenic heterotopia in the colon, using material obtained by endoscopic ultrasound and ultrasound-guided biopsy.
本病例报告旨在描述一例前所未有的病例，通过内镜超声引导下活检获得的组织进行组织学和免疫组织化学诊断为结肠脾异位。
脾异位是一种良性疾病，其特征是脾组织植入远离其通常解剖部位的部位，如腹膜、网膜、肠系膜、肝、胰腺和皮下组织，且更罕见于结肠和脑等部位。它通常与脾外伤或脾切除术史有关，通常不会引起特定的症状。
一名 35 岁白人男性，健康，无外伤或脾切除术史，但有结直肠肿瘤家族史，行结肠镜筛查。检查显示近端降结肠有一个大的隆起，覆盖着正常的黏膜。进行了内镜超声引导下穿刺，使用 22 号细针进行活检，组织病理学和免疫组织化学分析结果与脾异位一致。
这是首例使用内镜超声和超声引导活检获得的组织进行组织学和免疫组织化学诊断为结肠脾异位的原发性固有肌层结肠脾异位病例报告。
