A CASE REPORT OF COLITIS CYSTICA PROFUNDA

Abstract

Colitis cystica profunda is a rare benign disease, and only 21 cases (including this case) have been reported up to the present in Japan. The patient, a 27 year-old male, had complained of diarrhea, anal pain, anal prolapse of tumor and anal bleeding for the past 2 years. Laboratory studies on admission revealed no abnormality. Digital examination revealed irregular-size elastic hard tumors on the anterior wall of the rectum. On barium enema examination, multiple nodularly elevated lesions were found in the rectum. Endoscopically, irregular-sized tumors were found and the color of covering mucosa looked whitish. The biopsy specimen showed only chronic inflammation of the mucosa and no sub-mucosal tissue was obtained. A local resection of the lesion was performed. The cross section of the resected specimen revealed multiple cysts containing yellow-brownish colored mucus. Microscopically, multiple cysts filled with serous fluid were noticed in the submucosal layer. From these findings, the case was diagnosed to be colitis cystica profunda. Colitis cystica profunda is a benign disease and local resection is indicated. Because of the difficulty in making correct diagnosis with the preoperative biopsy specimen the lesions were, sometimes, misdiagnosed as malignant and unnecessary radical operations were performed. We must know this disease in order to avoid confusion with a mucus producing adenocarcinoma at the time of biopsy. It is necessary to investigate whether colitis cystica profunda is a kind of paracancerous lesion or not.