A Case of Enteritis Cystica Profunda Accompanied by a Lipoma in the Duodenal Bulb

Abstract

Enteritis cystica profunda (ECP) is a very rare hyperplastic benign lesion of the small intestine. Histologically, it is characterized by mucin-filled cystic spaces frequently lined by benign epithelium within the submucosa and muscularis propria. ECP occurs much less frequently than gastritis cystica profunda (GCP) or colitis cystica profunda (CCP). It is most often seen in adults with Crohn's disease, Peutz-Jeghers syndrome, hamartomatous polyp, or congenital anomalies. We encountered a case of ECP (90 × 15 mm) accompanied by an elongated lipoma in the duodenal bulb, in the absence of any other disease. An endoscopic polypectomy proved sufficient for diagnosing and treating the ECP. To our knowledge, this is the first reported case of ECP accompanied by a lipoma in the duodenal bulb in the absence of any other intestinal disease.

Enteritis cystica profunda with lipoma in the second portion of the duodenum: a case report

“…The most common type is colitis CP, followed by ECP and gastritis CP [1,4]. ECP develops most frequently in the ileum or jejunum with associated diseases [2][3][4][5][6][7][8][9][10][11][12][13][14]19]. However, ECP in the duodenum is the least common and is mostly without causative conditions [15][16][17][18].…”

“…CP is also found in therapeutically irradiated tissues along with surgical anastomosis site and rarely occurs without an etiology [1]. ECP generally develops with Crohn disease and Peutz-Jeghers syndrome, rarely with conditions such as hamartoma, trauma, and primary eosinophilic enteritis, and sometimes without any underlying condition [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. These pathological conditions result in a persistent chronic injury, that, through ulceration and repair, leads to entrapment of glands deep in the intestinal wall [1].…”

“…Enteritis cystica profunda (ECP), a rare and nonneoplastic condition, is defined as the displacement of the glandular epithelium into the submucosa or more profound layers of the small intestinal wall and characterized by mucin-filled cystic spaces [1]. ECP occurs mainly in the ileum or jejunum and is related to diseases such as Crohn disease and Peutz-Jeghers syndrome [2][3][4][5][6][7][8][9][10][11][12][13][14]. ECP also develops without associated conditions [15][16][17][18][19][20].…”

“…One report described a case of ECP coexisting with lipoma in the duodenal bulb [18]. In the foreign literature also, ECP cases are rare, and only one case of ECP coexisting with lipoma in the ileum has been reported [4][5][6][7][8][9][10][11][12]19]. The authors detected an approximately 3.5 × 1.5 × 1.0 cm elongated polyp in the second portion of the duodenum distal to the ampulla of Vater (AOV), through esophagogastroduodenoscopy, in a patient without an underlying disease.…”