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Endoscopic features ot Lipohyperplasia m the Large Intestine
Author(s) -
YAMAMOTO Hitoshi,
KUSUGAMI Kazuo,
ANDO Takafumi,
INA Kenji,
SHINODA Masataka,
YAMAGUCHI Takeo,
KONAGAYA Toshihiro,
ITOH Shingo,
UCHIDA Kiyoshi,
HAYASHI Nobuyuki,
HAYASHI Ryuichi,
SAITO Yuichiro,
SUGIE Motohiko
Publication year - 1996
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1996.tb00440.x
Subject(s) - ileocecal valve , medicine , cecum , ascending colon , lesion , rectum , large intestine , anatomy , pathology , gastroenterology , ileum
We reviewed 18 cases of large intestinal lipohyperplasia (LPH) to clarify the clinical and endoscopic features of this lesion. LPH was found in the ileocecal valve in 16 patients (88.9%). On colonoscopic examination, LPH showed a submucosal tumor‐like lesion with a smooth surface. The color was slightly yellowish or the same as that of the surrounding mucosa and the cushion sign was positive in all cases. According to endoscopic features, LPH in the ileocecal valve was classified into three types. The diffuse type showed a symmetrically swollen ileocecal valve. In contrast, the localized type displayed polypoid protrusion from the ileocecal valve. The intermediate type showed partial protrusion with asymmetrical swelling of the valve. Four patients had the diffuse type, three the intermediate type and nine the localized type. The upper lip of the ileocecal valve was more frequently involved in the localized and intermediate types. On rare occasion, LPH was recognized as hemispherical mucosal elevation in the ascending colon and rectum. Histological examination revealed infiltration of mature adipose tissue in the submucosal layer. It was noted that five of the 18 patients had associated malignancies of the gastrointestinal tract. As to therapy, six patients received endoscopic polypectomy and one underwent right hemicolectomy for associated advanced cancer in the cecum. In summary, this review shows that LPH is recognized primarily as focal or diffuse swelling of the ileocecal valve. On colonoscopic examination the possibility of such a lesion in the ileocecal valve should be kept in mind.