Abstract
We report a rare case of intestinal endometriosis with an endometrial tissue recognized in the main lymph node. The patient was a 49-year-old woman who came to our hospital for emergency visit with a chief complaint of right lower abdominal pain. Medical examination revealed right lower abdominal pain with peritoneal signs and marked increase in the inflammatory response. Heterogeneous contrast effect with a size of approximately 4 cm in the ileocecal region and surrounding enlarged lymph node were recognized on contrast-enhanced computed tomography. Thus, we conducted an emergency ileocecal resection, including D3 lymphadenectomy, owing to suspicion of secondary perforated appendicitis/abscess formation by the tumor. We diagnosed the condition as intestinal endometriosis based on the immunostaining findings when we histopathologically recognized that the gland duct was similar to the uterine gland from the appendix/ileum submucosa to the tela subserosa. In addition, we also found an endometrial tissue in #203 as an appendicular lymph node. Since we have experienced an extremely rare case of intestinal endometriosis with the endometrial tissue recognized in the main lymph node in Japan, we report this case with some literature review.
