title: Idiopathic myointimal hyperplasia of mesenteric veins: Rare case of ischemic colitis mimicking inflammatory bowel disease.
abstract: Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare and poorly understood ischemic colitis that occurs in the rectosigmoid colon of predominantly young, previously healthy, male patients. A 76-year-old Japanese man presented to our hospital with a 1-year history of worsening diarrhea, lower abdominal pain, and weight loss (-6 kg). Laboratory evaluation revealed white blood cell count of 13,200/μL, C-reactive protein level of 2.0 mg/dL (normal range, 0.0-0.3), and negative results for stool culture (including Clostridium difficile). Colonoscopy showed circumferential and edematous narrowing of the sigmoid colon with deep longitude ulceration. Biopsy was done and examination of the specimen demonstrated no specific ischemia. The patient was treated with bowel rest, antibiotics, and i.v. fluids; however, his symptoms worsened. Finally, sigmoidectomy was carried out. Histological examination demonstrated significant myointimal hyperplasia of mesenteric veins leading to thickening and stenosis of the venous lumen. Therefore, the final diagnosis was IMHMV. Three months following sigmoidectomy, he was asymptomatic.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Sahara
authors.affiliation: Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Rin
authors.initials: R
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterological Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Department of Gastroenterological Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Koizumi
authors.affiliation: Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Horiguchi
authors.affiliation: Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Hishima
authors.affiliation: Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D001706:Biopsy; D017091:Colitis, Ischemic / Q000175:diagnosis*; D012809:Colon, Sigmoid / Q000098:blood supply* / Q000473:pathology; D003113:Colonoscopy; D003937:Diagnosis, Differential; D006801:Humans; D006965:Hyperplasia; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: colon; idiopathic myointimal hyperplasia of mesenteric veins; inflammatory bowel disease; ischemia; mesenteric veins