Pulse granuloma of the rectum: an unusual entity

Gupta, Ashutosh; Lyapichev, Kirill A.; Rojas, Claudia

doi:10.1111/his.12875

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…It is a pseudotumor that results from the entrapment of food introduced through mucosal trauma. Variable presence of hyaline ribbons and rings, inflammation, foreign body giant cells, calcifications, and vegetable food may be observed [ 52 , 53 , 54 ]. In hyaline dominant cases with no inflammatory cells, polariscopy may fail to detect vegetable matter.…”

Section: ⧉ Discussionmentioning

confidence: 99%

Abdominal elastotic lesions. A clinicopathologic study of 23 cases

Val‐Bernal

Mayorga²,

García-Gutierrez³

2021

Rom J Morphol Embryol

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Abdominal elastotic deposits are uncommon lesions that often presents as polyps. They show three histological patterns: fibroelastosis, angioelastosis, and elastofibroma. We describe 23 cases including rare locations, such as mesentery, greater omentum, hernia sac, spleen, peripancreatic fat, and hypodermal fat. The age of the patients ranged from 49 to 93 years (mean, 76.8 years). Most lesions were discovered incidentally in the microscopic study. The most frequent locations were peritoneal subserosa (43.5%) and mesentery/mesocolon/greater omentum (39.1%). The most common pattern was fibroelastosis (69.6%) followed by angioelastosis (26.1%). We observed one case of omental elastofibroma. A review of the 14 abdominal elastofibromas described including our case revealed that the age of the patients ranged from 45 to 88 years (mean, 68.5 years). Female predominance is striking (M:F, 1:12). The most common site was the stomach (50%). The greater omentum (14.3%), small intestine (7.1%), and pancreas (7.1%) are very rare sites for this lesion. Only one case before ours has been published in the greater omentum. The size of the lesions ranged from 0.7 cm to 8 cm (mean 3.2 cm). In 36.4% of the cases located in the digestive tract, the mucosa did not show alterations. Ulcerations (36.4%) or polypoid excrescences (18.2%) were mostly observed. Six (42.9%) cases were asymptomatic and six (42.9%) cases simulated a neoplasm. Two cases were associated with elastofibromas in other locations. Differential diagnosis includes amyloidoma, elastofibrolipoma, mesenteric elastic vascular sclerosis in neuroendocrine tumors, diverticular disease elastosis, pseudoxanthoma elasticum, pulse granuloma, and digestive lesions in patients treated with D-Penicillamine.

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Section: ⧉ Discussionmentioning

confidence: 99%

Abdominal elastotic lesions. A clinicopathologic study of 23 cases

Val‐Bernal

Mayorga²,

García-Gutierrez³

2021

Rom J Morphol Embryol

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“…Since then, only 21 cases of GIT pulse granulomas were reported, mainly in a case-series of 17 patients by Nowacki et al in 2015. 9,10 In this study, all patients had a history of intestinal injury such as diverticulitis, fistula, ulcerative colitis, perforation, malignant tumor, appendicitis, anastomotic leak, and/or stent leak. Pulse granulomas were in most cases nodular (95%), localized over the external surface of the bowel (90%) and multifocal (68%).…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Pulse Granulomas With Spiral Bodies Mimicking Peritoneal Carcinomatosis: A Case Report

et al. 2018

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Pulse (hyaline ring) granuloma, a rare entity first described in lung and oral cavity, has been reported under various names before the identification of hyaline rings as fragments of pulses (the edible seeds of legumes). Similar lesions were thereafter described in extra-oral localizations, mainly the gastrointestinal tract, or localizations having potential communication with the gastrointestinal tract. Recently, 2 reports described "spiral bodies" surrounded by foreign body-type multinucleated giant cell reaction in pulse granulomas, corresponding to remnant plant vascular structures (helical xylem elements). In this article, we report a case of a 70-year-old male patient presenting to our hospital for an incisional hernia repair. He had a history of antrectomy 2 years previously for perforated duodenal ulcer complicated with fecal peritonitis. During the hernia repair procedure, multiple peritoneal whitish nodules and one subserosal appendiceal nodule were found. Appendectomy and biopsy of a peritoneal nodule were performed. Microscopic examination showed nodular lesions located in the subserosa to be pulse granulomas. Also surrounded by histiocytes, spiraled thin and rigid foreign bodies were identified. In this article, we report a case of pulse granuloma with spiral bodies complicating perforated duodenal ulcer and mimicking a peritoneal carcinomatosis. We also provide a discussion on the origin of spiral bodies in light of relevant literature.

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“…The majority of pulse granulomas occur in the oral cavity mandible. 1,2,4,5 However, they have also been more recently described in nasal cavity, 6 prostate, 7 cervix, 8 fallopian tube and ovary, 9 gallbladder, 9 skin, 9 lymph node, 8 gastrointestinal tract (colorectum, small intestine, appendix, and stomach), 3,10-12 and urinary bladder. 13…”

Section: Discussionmentioning

confidence: 99%

A Peculiar Form of Breast Fat Necrosis Simulating Hyaline Ring Granuloma (So-called Pulse Granuloma): A Rare Complication of Hyperparathyroidism

García-Martos

Panizo-Santos

2017

Int J Surg Pathol

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Pulse granuloma is a rare, foreign body inflammatory reaction that occurs mainly in the oral cavity. It is exceedingly rare elsewhere, with only isolated cases described in the literature. We report the case of a 79-year-old woman with a history of normocalcemic hyperparathyroidism who presented to our hospital with a painful 4-cm lump in the upper quadrants-upper outer quadrant of her left breast. The clinical and radiological (BIRADS-5) findings were indicative of a malignant lesion. However, core needle biopsy revealed features simulating hyaline ring granuloma (pulse granuloma-like). A definitive diagnosis of lipomembranous fat necrosis was made by identifying its characteristic histomorphology. Histopathological study is essential to establish an exact diagnosis since clinical and imaging features may mimic breast carcinoma. To our knowledge, this is the first reported case of a hyaline ring granuloma-like in the breast, which may represent a peculiar form of degenerative change of lipomembranous fat necrosis.

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Pulse granuloma of the rectum: an unusual entity

Cited by 5 publications

References 6 publications

Abdominal elastotic lesions. A clinicopathologic study of 23 cases

Abdominal elastotic lesions. A clinicopathologic study of 23 cases

Peritoneal Pulse Granulomas With Spiral Bodies Mimicking Peritoneal Carcinomatosis: A Case Report

A Peculiar Form of Breast Fat Necrosis Simulating Hyaline Ring Granuloma (So-called Pulse Granuloma): A Rare Complication of Hyperparathyroidism

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