A case of colitis cystica profunda in a patient with diverticulosis

MRI Appearances Of Colitis Cystica Profunda: A Rare Benign Mimicker Of Colorectal Malignancy

“…CCP is a benign condition with reactive changes in mucosa, characterised by submucosal cysts filled with mucin and lined by benign epithelium which might imitate carcinoma of colon from a radiologic and pathologic viewpoint. 2,7 CCP can present in a localised form with a polypoid lesion, or as a diffuse process involving a variable length of the rectal mucosa or colon, having predilection for male gender. 3,8,9 The etiology of this entity is not fully elucidated, but it has been described to have inflammatory/post traumatic origin with associations with a number of ulcerating diseases including inflammatory bowel disease, SRUS, diverticulosis, and infectious colitis.…”

“…6 Endoscopic anorectal ultrasound can be diagnostic by showing hypoechoic signal in the submucosal layer without adjacent deeper or muscular layer involvement, which clearly differentiates benign from malignant disease process. 2,6 MRI typically reveals cystic, non-infiltrative, submucosal lesions with thickening of levator ani muscles, some loss of perirectal fat tissue or nodules with high signals on T2 sequences due to mucoprotein content of the cysts. 3,8,9 Removal of lesions by colonoscopy, followed by histopathology, is the gold-standard for clinching the final diagnosis.…”

“…Colitis cystica profunda (CCP) is an unusual benign recto-colonic condition characterised by intramural mucin-filled cysts; which, because of its clinical expression and the way it appears on imaging studies, can mimick neoplasm of colon. 1,2 Stark first described it in the colon of two autopsied cases of chronic dysentery and Vinchow was the one to name it 'colitis cystica polyposa'. [2][3][4][5][6] Rectum and the sigmoid colon are the commonest sites of affliction, but wide colonic distribution is also seen.…”

“…1,2 Stark first described it in the colon of two autopsied cases of chronic dysentery and Vinchow was the one to name it 'colitis cystica polyposa'. [2][3][4][5][6] Rectum and the sigmoid colon are the commonest sites of affliction, but wide colonic distribution is also seen. 2 CCP has similar histological features as solitary rectal ulcer syndrome (SRUS) and the overlap between these conditions is not fully elucidated.…”

“…[2][3][4][5][6] Rectum and the sigmoid colon are the commonest sites of affliction, but wide colonic distribution is also seen. 2 CCP has similar histological features as solitary rectal ulcer syndrome (SRUS) and the overlap between these conditions is not fully elucidated. CCP usually presents with nonspecific symptoms of mucorrhea, abdominal pain, rectal bleeding, tenesmus, and constipation; frequently misdiagnosed or confused with a malignancy, sometimes resulting in unnecessary interventions, be it surgical or pharmacological.…”