title: [A Case of Xanthogranulomatous Inflammation of Terminal Ileum Presenting as a Mass in a Woman with Severe Obesity].
abstract: Xanthogranulomatous inflammation is an acute or chronic inflammatory condition most frequently reported in pyelonephritis and cholecystitis. However, the involvement of the terminal ileum is extremely rare. Its clinical significance is that it can m imic a malignant lesion clinically and intraoperatively, as well as radiographically. A 34-year-old European ethnic female presented with gradually aggravated abdominal pain in right lower quadrant for 15 days. There was no significant medical, surgical or traumatic history, except class III obesity (BMI, 41.0 kg/m2). An abdominal CT showed about a 4.7×3.7 cm sized, mass-like lesion in the terminal ileum. Despite symp tomatic treatment, her clinical symptoms did not improve. After six days, she underwent a laparoscopic ileocecectomy. Pathologic findings showed extensive inflammation with occasional multinucleated giant cells and aggregates of foamy histiocytes, consistent with xanthogran ulomatous inflammation. Here, we present a case of xanthogranu-lomatous inflammation in the terminal ileum presenting as subacute abdominal pain and a mass on imaging study. Xanthogranulomatous inflammation should be added to the differential diagnosis of patients with a suspected mass-like lesion in the terminal ileum.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Hyung Ku
authors.initials: HK
authors.lastname: Chon
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D015992:Body Mass Index; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009767:Obesity, Morbid / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014973:Xanthomatosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
keywords: Ileum; Morbid obesity; Xanthogranulomatous