Systemic phlebitis of visceral veins with intramural giant cell granulomas--a new entity?

We report a case of granulomatous giant cell poly-phlebitis of the mesenteric veins in a 38-year-old man, resulting in a segmental infarction of the ileum. Multiple epithelioid granulomas with giant cells of the Langhans type were situated in media/adventitia of small and middle-sized mesenteric veins with subsequent thrombotic occlusions. No involvement of arterial vessels could be detected. The etiology of the disease remains unknown. Any known type of vasculitis could be excluded. An immunology-related vasculopathy is assumed, but could not be definitely proved. This is the first case of a granulomatous giant cell poly-phlebitis of visceral veins reported in the world literature.