Polypoid arteriovenous malformation of colon mimicking inflammatory fibroid polyp

Abstract

Arteriovenous malformation is a well-known cause of lower gastrointestinal bleeding in the elderly and usually appears as flat or elevated bright red lesions endoscopically. Here we present a 59-year-old woman with a large fungating polypoid mass in the transverse colon. Histologically, the larger vessels were located mainly in the submucosa, and smaller vessels were also observed within the mucosa. Verhoeff's elastic stain showed internal and external elastic lamina in the malformed vessels. We report an extremely rare case of a large, pedunculated, polypoid arterioveneous malformation with the first description of our complete pathological findings.

Polypoid arteriovenous malformation in the jejunum of a child that mimics intussusception

“…In adults, there have been at least 7 cases (Table 1) of PAVM reported [2][3][4][5][6][7]. All of these cases, which occurred only in patients older than 40 years with no sex bias, involved the colon.…”

“…Most of the cases were initially mistaken for a polyp; and as such, 5 of these cases were treated by performing a polypectomy, whereas one was treated by performing a bowel resection owing to its large size and yet another one was treated via loop diathermy that required epinephrine and argon plasma coagulation owing to excessive bleeding [5]. The case reported by Maeng et al [5] was confounded with an inflammatory fibroid polyp in an endoscope biopsy owing to the presence of an infiltrate of lymphocytes and eosinophils in the lamina propria. However, in our case, the density of the infiltrate and the prominence of a fibroblasticmyofibroblastic presence obligated us to pursue this issue further.…”

“…Polypoid arteriovenous malformations (PAVMs) are very rare; and only 7 cases have been reported in the English medical literature, where all of them were observed in adults and were localized in the colon [2][3][4][5][6][7]. We report the first case of PAVM observed in a child that was localized in the jejunum and was characterized with a clinical and radiographic manifestation resembling intussusception.…”

Intraoperative localization of arteriovenous malformation of a jejunum with combined use of angiographic methods and indocyanine green injection: Report of a new technique

“…However, the clinically distinguishing vascular malformation is sometimes difficult because these lesions have similar endoscopic appearances. Intestinal AVMs have been described as flat or mildly elevated hemorrhagic spots or erosions, whereas others lesions appear as a mass or polypoid lesions [7], [8], [9]. Therefore, in our case, the bleeding source could not be detected by a double-balloon enteroscopy.…”

Ischemic Colitis Associated with Segmental Arteriovenous Malformation Mimicking Inflammatory Bowel Disease in a Familial Adenomatous Polyposis Patient

“…The pathology of AVM in the colon tends to be the same as AVM in the soft tissue [7]. In the intestine, however, it is also known as vascular ectasia or angiodysplasia.…”