Presentation
Crypt abscesses may be present Granulomas are present in about 15-36% of biopsied cases Present in over half of colectomy specimens Compact aggregates of epithelioid histiocytes Non-necrotic Multinucleated giant cells may be present May be seen at all [surgpathcriteria.stanford.edu]
It primarily affects children, and it is usually asymptomatic; however, it may present with abdominal pain, chronic diarrhea, bleeding, or intestinal obstruction[ 1, 4 ]. [e-sciencecentral.org]
During her initial presentation, she initially was given an empiric trial of dicylcomine with improvement in pain. Subsequently, she presented to an emergency room due to abdominal pain, where a CT scan was done. [healio.com]
In this case report, the complexity of the clinical presentations in CVID patients was stressed. [ijpmonline.org]
Diffuse nodular lymphoidhyperplasia with selective IgA deficiency syndrome presenting with intestinal lymphoma. MOJ Clin Med Case Rep. 2016;4(5):116‒118. [medcraveonline.com]
Entire Body System
- Asymptomatic
It primarily affects children, and it is usually asymptomatic; however, it may present with abdominal pain, chronic diarrhea, bleeding, or intestinal obstruction[ 1, 4 ]. [e-sciencecentral.org]
Butterworths. 1983 Lymphoid hyperplasia “The last form of NLH is that restricted to the terminal ileum which has also been termed benign lymphoid hyperplasia due to the frequency of its demonstration in asymptomatic children. [briandeer.com]
[…] reports had described DNLH in adult patients without immunodeficiency and it was thought to be associated with chronic GIT infections such as Giardiasis or Helicobacter pylori infection. 4, 8, 10 Nodular lymphoid hyperplasia generally presents as an asymptomatic [medcraveonline.com]
Deep fissures frequent No fissures or deep ulcers Incidental Chronic Colitis Crohn Disease Isolated disease Usually multifocal Virtually restricted to cecum/right colon May involve entire GI tract No granulomas Granulomas may be present Incidental, asymptomatic [surgpathcriteria.stanford.edu]
It can manifest an asymptomatic disease or gastrointestinal symptoms like diffuse abdominal pain, chronic diarrhea, and bleeding [ 5 ]. [medsci.org]
- Pathologist
Whenever a malignant diagnosis is being considered benign reactive disorders must be ruled out by an experienced pathologist. This is the final page of the Benign White Cell Disorders. The next page begins the Leukemia section. [med-ed.virginia.edu]
Jejunum Uncommonly seen by pathologists. May be seen in the context of a resection done for a bowel obstruction. Ileum This is seen occasionally -- often in the context of IBD and more specifically Crohn's disease. [librepathology.org]
[…] surface Reactive atypia rarely extends to the luminal surface Dysplasia may be focal, requiring adequate sampling Recommended sampling is 4 biopsies every 10 cm of colorectum A diagnosis of dysplasia should be confirmed by an experienced gastrointestinal pathologist [surgpathcriteria.stanford.edu]
- Pallor
Pallor & Polyps Symptom Checker: Possible causes include Sinusitis & Upper Respiratory Infection & Pharyngitis. [ujrpbg.tk] Uncommonly, cancers or polyps may cause a sore throat. [ujrpbg.tk]
Table-1: Symptom and sign of patients with NLH Signs & symptoms N(12 cases) Diarrhea 11 Weight loss 11 Abdominal pain 12 Lymphadenopathy 01 Pallor 10 Chronic cough 01 Arthralgia 01 Neuropthy Nil Table-2: Mucosal biopsies from patient with NLH Abnormality [medresearch.in]
- Weakness
Lethargy & Polyps Symptom Checker: Possible causes include Appendicitis & Malignant [ujrpbg.tk], malaise, weakness,Pallor, lethargy, malaise, weakness, and colonic adenocarcinoma, the classic features of familial polyposis coli. enamel Hamartomatous rectal [ujrpbg.tk]
Respiratoric
- Pneumonia
Clinical findings Range from mild GI discomfort (in IgA deficiency) to severe malabsorption, chronic diarrhoea, recurrent bacterial infections with sinusitis, bronchitis, bronchiectasis, pneumonia (in CVID). [medical-dictionary.thefreedictionary.com]
There had not been any history of recurrent infections, such as sinusitis, bronchitis, pneumonia or otitis. [ijpmonline.org]
It is also known as acquired hypogammaglobulinemia because of a generally later age of onset of infections.The majority of patients have at least one episode of pneumonia prior to diagnosis. [latunisiemedicale.com]
- Aspiration
None of the patients had Giardia lamblia infection as evaluated by examinations of concentrated, iodine-stained wet stool preparations; duodenal aspirates and duodenal biopsies. [bmcgastroenterol.biomedcentral.com]
However, flow cytometric analysis of a bone marrow aspirate revealed minimal involvement by a clonal B-cell population coexpressing CD19 and CD5, suggesting the presence of circulating lymphoma cells. [nature.com]
Gastrointestinal
- Diarrhea
Diarrhea and abdominal pain were not alleviated until he was treated with monthly fresh frozen plasma infusions. [pediatrics.aappublications.org]
For patients with chronic diarrhea repeated courses of antibiotics such as quinolones or metronidazole had been reported. [medcraveonline.com]
Malabsorption and diarrhea occur in 9 to 40% of patients with CVID. [ijpmonline.org]
diarrhea without hematochezia. + p < 0.05 versus hematochezia without diarrhea. [medsci.org]
It primarily affects children, and it is usually asymptomatic; however, it may present with abdominal pain, chronic diarrhea, bleeding, or intestinal obstruction[ 1, 4 ]. [e-sciencecentral.org]
- Chronic Diarrhea
It is to be emphasized that other forms of chronic diarrhea not related to immunoglobuun deficiencies do not respond to this type of therapy. [pediatrics.aappublications.org]
For patients with chronic diarrhea repeated courses of antibiotics such as quinolones or metronidazole had been reported. [medcraveonline.com]
We present a case of nodular lymphoid hyperplasia (NLH) of the small intestine in a 31-year-old man admitted for evaluation of chronic diarrhea. [ijpmonline.org]
It primarily affects children, and it is usually asymptomatic; however, it may present with abdominal pain, chronic diarrhea, bleeding, or intestinal obstruction[ 1, 4 ]. [e-sciencecentral.org]
Accompanying diseases We observed that 15 patients had chronic diarrhea, the main symptoms were diarrhea and abdominal pain. [medsci.org]
- Intestinal Disease
Problems with the small intestine can include: Bleeding Celiac disease Crohn's disease Infections Intestinal cancer Intestinal obstruction Irritable bowel syndrome Ulcers, such as peptic ulcer Treatment of disorders of the small intestine depends on the [icdlist.com]
Immunoproliferative small intestinal disease, / Mediterranean lymphoma: B-cell lymphoma usually arises in children and young adults with Mediterranean ancestry. Usually located in the distal portion of duodenum and upper jejunum. [histopathology-india.net]
Khojasteh A, Haghshenass M, Haghighi P (1983) Immunoproliferative small intestinal disease: A “Third-World lesion”. N Engl J Med 308:1401–1405 Google Scholar 16. [link.springer.com]
Familial adenomatous polyposis (FAP) and intestinal lymphoma should be taken into consideration. GIT is considered the largest lymphoid system in the body, so intestinal diseases are not surprisingly associated with the immunodeficiency syndromes. [medcraveonline.com]
About half of the cases of lymphomatoid polyposis reported had an intestinal mass, mainly at the ileocecal region, which may be the primary site of the disease ( 11 ). [nature.com]
- Steatorrhea
In a small minority, immunodeficiencies underlie the hyperplastic state.2 Some patients have low or absent IgA and IgM levels, decreased IgG levels, susceptibility to infection, and diarrhea with or without steatorrhea. [answers.yahoo.com]
Whatever the mechanism, it seems to be systemic, since the locally acting oral bethamethasone-17-valerate, which has been shown to induce remission in patients with idiopathic steatorrhea, was ineffective [10]. [latunisiemedicale.com]
View Article PubMed Google Scholar Crabbe PA, Heremans JF: Selective IgA deficiency with steatorrhea. Am J Med. 1967, 42: 319-26. 10.1016/0002-9343(67)90031-9. [bmcgastroenterol.biomedcentral.com]
- Dyspepsia
They suggest looking for risk factors in CVID patients, such as Helicobacter pylori infection, pernicious anemia, or dyspepsia, prior to initiating screening esophagogastroduodenoscopy (EGD). [acgcasereports.gi.org]
Patients presented with intractable dyspepsia and esophagogastroduodenoscopy showed diffuse nodular lesions of varying grades involving postbulbar duodenum. [bmcgastroenterol.biomedcentral.com]
Eyes
- Prolapse
Although early treatment has a great outcome, there is always a risk of recurrent prolapse. [news-medical.net]
prolapsed cecum 569.89 colon (pedunculated) 569.89 intestine (small) 569.89 Ptosis (adiposa) 374.30 cecum 569.89 colon 569.89 intestine 569.89 splanchnic 569.89 viscera 569.89 Putrefaction, intestinal 569.89 Rectosigmoiditis 569.89 Rupture, ruptured [icd9data.com]
The clinical significance of lymphoid hyperplasia lies in the possibility of these nodules serving as a nidus for prolapse and intussusception and in the association with immunosuppressive states. [answers.yahoo.com]
[…] and always requires clinical correlation Rare cases deviate from some of these criteria Up to 15% of cases may be indeterminate even after full evaluation pANCA and ASCA have considerable overlap and are felt by some to lack clinical utility Mucosal Prolapse [surgpathcriteria.stanford.edu]
Workup
Microbiology
- Giardia Lamblia
There was no Giardia lamblia infection in our data, and the reports on Giardia lamblia infection have been found mainly in the duodenum [ 23, 24 ]. [medsci.org]
Microscopic examination of the feces didn’t reveal Giardia lamblia. Chest X-ray showed bilateral bronchiectases predominant in the lower lobes and on the right side. [latunisiemedicale.com]
lamblia may create a nodular mucosal pattern. 2 There have been suggestions that NLH is a risk factor for intestinal and extra-intestinal lymphoma. 3 Abolhassani et al emphasized the need for an endoscopic surveillance protocol for gastric cancer in [acgcasereports.gi.org]
Biopsies were examined for viral inclusions and parasites especially Giardia lamblia [ 24 ]. H. pylori infection was evaluated by rapid urease test (RUT) and at histology. [bmcgastroenterol.biomedcentral.com]
It was suggested by various studies that Giardia lamblia is one of the commonest infection seen in these cases [10]. [medresearch.in]
Treatment
Surgical treatment has been suggested in the management of this disorder. We report 2 cases in which recurrent intussusception was associated with ILH. A short course of steroids resulted in resolution of both symptoms and hyperplasia. [ncbi.nlm.nih.gov]
Following up patients without any treatment may lead to malignant progression, while surgical treatment may result in justified radical resections. [medcraveonline.com]
Polyps In Rectum Polypectomy Syndrome Acne Treatment Home Remedies And Diabetes Wikihow Animal Jam Allergy Treatments With Quran In English derivatives optometrist own, cialis pharmacy hamartomatous pneumothorax. [ujrpbg.tk]
Treatment may involve diet, medicines and in some cases, surgery. [icdlist.com]
This clinical condition is of particular interest because of the unusual pathology and the lack of an efficient treatment. [minervamedica.it]
Prognosis
Pulmonary malignant lymphomas and pseudolymphomas: classification, therapy, and prognosis. Cancer. 1963;16:928–955. Okubo H, Maekawa H, Ogawa K, Wada R, Sekigawa I, Iida N, Maekawa T, Hashimoto H, Sato N. [genrevista.org]
Dark Spots on Skin Influenced by Genetic Factors (Peutz-Jeghers Syndrome) Syndrome or BWS|Causes|Symptoms|Treatment|Prognosis Nicu Nursing Cowden's syndrome, a PTEN hamartoma tumor syndrome, was suspected.. pigmented mucocutaneous macules and multiple [ujrpbg.tk]
Recent series have shown that intestinal mantle cell lymphomas tend to present at advanced stages and carry a poor prognosis ( 10, 11 ). [nature.com]
It usually runs a benign and self-limiting course in children whereas in adults the prognosis is uncertain [6]. [medresearch.in]
Etiology
DLNH is a rare benign condition of unknown etiology that may occur in any age group. 1 It usually regresses in children and it was thought to be associated with delayed type of food hypersensitivity. [medcraveonline.com]
Each of these morphologically recognizable patterns is associated with certain antigenic stimuli, thus the morphologic type of lymphadenopathy may offer clues as to the etiology of the lymphadenopathy. [med-ed.virginia.edu]
PULMONARY HAMARTOMA -Other etiologies of solitary pulmonary nodules must be .. 4 Ways to Get Rid of Fleas Naturally - wikiHow Flea Treatment, Natural Flea Remedies .. [ujrpbg.tk]
Here, we report on a large cohort of patients with NLH, etiologically related to H. pylori infection. [bmcgastroenterol.biomedcentral.com]
Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection. BMC Gastroenterology. 2011;11:36. Garg V, Lipka S, Rizvon K, Singh J, Rashid S, Mustacchia P. [revistagastrocol.com]
Epidemiology
Epidemiology and Clinical Presentation Infants in their 6th – 36th month of life, presenting with intestinal obstruction, more often than not have intussusception as the cause. [news-medical.net]
Nonprotruding colorectal neoplasms: epidemiologic viewpoint. World J Surg. 2000;24(9):1098-103. Khuroo MS, Khuroo NS, Khuroo MS. [revistagastrocol.com]
Epidemiology. 2008; 19: 71-74. doi. 10.1097/EDE.0b013e31815c1dd3 Coulibaly B, et al. Benign lymphoid polyposis: two diffuse cases leading to fatal intestinal ischemia in children. [medigraphic.com]
Conclusion There are several missing links in NLH, such as epidemiological data and non-invasive method to follow up such cases. [medresearch.in]
Pathophysiology
Pathophysiology of LNH GI mucosal lymphatic tissue consists of inductive and effector compartments [ 23 ]. [abdominalkey.com]
Pathophysiology The part of the bowel that prolapses is called the intussusceptum and the distal part of the affected segment that receives the intussusceptum is called the intussuscipiens. [news-medical.net]
Prevention
Monogr Eval Carcinog Risks Hum. 1994, 61: 1- Google Scholar Malfertheiner P, Sipponen P, Naumann M, Moayyedi P, Mégraud F, Xiao SD, Sugano K, Nyrén O, Lejondal, H. pylori-Gastric Cancer Task Force: Helicobacter pylori eradication has the potential to prevent [bmcgastroenterol.biomedcentral.com]