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

Abstract

Colitis cystica profunda (CCP) is a rare benign disease characterised by mucin-filled cysts beneath the muscularis mucosae, which commonly involves the rectum and sigmoid colon. The disease process involving rectum is termed as proctitis cystica profunda. Trans-rectal ultrasound (TRUS) and magnetic resonance imaging (MRI) are an aid to diagnosis. However, histological analysis of deep biopsy is diagnostic. We report a case of 21-year male who presented with bleeding per rectum and was diagnosed as solitary ulcer of the rectum (SRUS) on superficial biopsies on sigmoidoscopy. Surgical intervention coupled with MRI findings and histopathological analysis formulated diagnosis of CCP. To our knowledge, we are second to report this entity with its MRI features.

Colitis cystica profunda: A report of two cases

“…The perirectal adipose tissue was absent, and the levator anus muscle was thickened 2,15 . MRI showed a homogeneous low signal on T1WI and a submucosal high signal nodule on T2WI, with no significant enhancement on contrast‐enhanced images, high signal on DWI, no diffusion restriction on ADC, and significant high signal on T2WI, suggesting the presence of mucin in the lesion 4,16 . In both cases in this paper, CT showed nonenhancing hypodense lesions with clear borders, calcifications at the margins, smooth mucosa, intact rectal wall, clear surrounding fatty spaces, and no enlarged lymph nodes.…”

Colitis cystica profunda: a two-patient case series

“…The perirectal adipose tissue was absent and the levator anus muscle was thickened [2,15] . MRI showed a homogeneous low signal on T1WI and a submucosal high signal nodule on T2WI, with no significant enhancement on contrast-enhanced images, high signal on DWI, no diffusion restriction on ADC, and significant high signal on T2WI suggesting that the presence of mucin in the lesion [4,16] . In both cases in this paper, CT showed non-enhancing hypodense lesions with clear borders, calcifications at the margins, smooth mucosa, intact rectal wall, clear surrounding fatty spaces, and no enlarged lymph nodes.…”