Diagnosis of colonic amebiasis and coexisting signet-ring cell carcinoma in intestinal biopsy.
Amebiasis is uncommon in developed countries. Several case reports in the literature emphasize that both the presenting symptoms and the radiological findings of colonic amebiasis closely resemble more common conditions, such as idiopathic inflammatory bowel disease and gastro-intestinal malignancy. We describe a unique case of colonic amebiasis (amebomas) coexisting with signet-ring cell carcinoma of the ileocecal valve, the cecum and the appendix. Endoscopically, the ulcerated tumor was indistinguishable from the ulcerations and pseudotumors (amebomas) detected in the ascending colon. Histological examination of biopsy specimens revealed the pathognomonic features of protozoa with ingested erythrocytes in combination with signet-ring cell infiltration. The author concludes that amebiasis may not only mimic carcinoma but, rarely, may coexist with carcinoma in the same patient. Clinicians and pathologists should be aware of this possibility in order not to delay diagnosis and treatment of malignant disease.
Alexandra Grosse, Institute of Clinical Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.
Alexandra
A
Grosse
D000328:Adult; D001706:Biopsy; D018279:Carcinoma, Signet Ring Cell / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003092:Colitis / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D003113:Colonoscopy; D003937:Diagnosis, Differential; D003967:Diarrhea; D004404:Dysentery, Amebic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008279:Magnetic Resonance Imaging
Colonic amebiasis; Colonoscopy; Colorectal carcinoma; Histopathology; Parasitic disease
PLoS Negl Trop Dis. 2015 Dec 03;9(12):e0004225
26633890
Lancet. 2003 Mar 22;361(9362):1025-34
12660071
Trop Parasitol. 2015 Jan-Jun;5(1):9-14
25709947
Acta Cytol. 1989 May-Jun;33(3):301-4
2728784
Ann Trop Med Parasitol. 2004 Jan;98(1):43-8
15000730
S Afr Med J. 1987 Nov 21;72(10):669-72
2891197
Gastrointest Endosc. 2004 Mar;59(3):453-4
14997156
Med Sante Trop. 2013 Jul-Sep;23(3):274-5
23797923
N Engl J Med. 2003 Apr 17;348(16):1565-73
12700377
Int J Clin Exp Pathol. 2014 Oct 15;7(11):8251-4
25550881
Trop Gastroenterol. 1992 Apr-Jun;13(2):64-9
1413101
Hong Kong Med J. 2006 Feb;12(1):71-3
16495594
Trop Doct. 2017 Jan;47(1):11-15
26834117
Lancet. 1985 Mar 30;1(8431):716-9
2857995
Br J Surg. 1976 Dec;63(12):966-8
188510
Am J Surg. 1987 Oct;154(4):451, 458, 462
3661852
Am J Trop Med Hyg. 1992 Jun;46(6):759-64
1621901
J Cancer Res Ther. 2014 Apr-Jun;10 (2):440-2
25022419
Tech Coloproctol. 2003 Apr;7(1):51-3
12750955
Eur J Clin Microbiol Infect Dis. 2008 Feb;27(2):133-7
17957394
Indian J Pathol Microbiol. 2009 Apr-Jun;52(2):228-30
19332922
Exp Parasitol. 2016 Feb;161:48-53
26684288
Exp Parasitol. 2010 Nov;126(3):366-80
20303955
Rev Infect Dis. 1986 Mar-Apr;8(2):228-38
2871619
World J Gastroenterol. 2007 Nov 14;13(42):5659-61
17948943
Case Rep Gastroenterol. 2013 Oct 09;7(3):438-41
24403882
Panminerva Med. 1963 Jun;5:159-62
14018317