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Intestinal Lymphoid Hyperplasia

Intestine Lymphoid Hyperplasia


Presentation

  • Diffuse nodular lymphoidhyperplasia with selective IgA deficiency syndrome presenting with intestinal lymphoma. MOJ Clin Med Case Rep. 2016;4(5):116‒118.[medcraveonline.com]
  • We experienced two cases of nodular lymphoid hyperplasia of the small intestine with hypogammaglobulinemia (IgA deficiency) and without hypogammaglobulinemia presented with epigastric discomfort.[e-ce.org]
  • 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]
Asymptomatic
  • […] 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]
  • 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]
  • 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]
Malaise
  • 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]
Cervical Lymphadenopathy
  • Physical examination of the patient was unremarkable apart from bilateral cervical lymphadenopathy previously biopsied.[medcraveonline.com]
Intestinal Disease
  • GIT is considered the largest lymphoid system in the body, so intestinal diseases are not surprisingly associated with the immunodeficiency syndromes.[medcraveonline.com]
  • Colonic Diseases Also called: Large intestine diseases Your colon, also known as the large intestine, is part of your digestive system. It's a long, hollow tube at the end of your digestive tract where your body makes and stores stool.[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]
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]
  • 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]
  • 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]
Intestinal Disease
  • GIT is considered the largest lymphoid system in the body, so intestinal diseases are not surprisingly associated with the immunodeficiency syndromes.[medcraveonline.com]
  • Colonic Diseases Also called: Large intestine diseases Your colon, also known as the large intestine, is part of your digestive system. It's a long, hollow tube at the end of your digestive tract where your body makes and stores stool.[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]
Suggestibility
  • 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]
  • 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]
  • […] with primary immunodeficiency syndromes 1 2 3 or the terminal ileum or colon (or both) of children without immunodeficiency. 4 In immunodeficient subjects, the association of NLH with non-Hodgkin's intestinal lymphoma seems extremely rare 5 6 7 and was suggested[nejm.org]
  • Considering the size of the nodules, minimum size for a hyperplastic nodule has been suggested to be 2 [ 8 ] or 4 mm [ 9 ].[abdominalkey.com]
  • […] of Medicine Stanford CA 94305-5342 Original posting : November 11, 2009 Differential Diagnosis Fungal, mycobacterial, amebic and other parasitic diseases must all be ruled out by close inspection and by laboratory tests Necrotic granulomas strongly suggest[surgpathcriteria.stanford.edu]

Workup

Lymphocytic Infiltrate
  • Histologic finding of the duodenal bulb showed small round mature lymphocyte infiltration and reactive follicle with germinal center in two cases. We report two cases with a brief reviews of literature.[e-ce.org]
  • There was a mild increase in lymphocytic infiltration of lamina propria of gastric mucosa without atypical lymphocytes and lymphoepithelial lesions. In small bowel mild villous blunting and atrophy without crypt hyperplasia was seen.[ijpmonline.org]

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]
  • This clinical condition is of particular interest because of the unusual pathology and the lack of an efficient treatment.[minervamedica.it]
  • An associated giardiasis was eliminated by atabrine therapy and a malabsorption syndrome, cleared after treatment with tetracycline. Diarrhea and abdominal pain were not alleviated until he was treated with monthly fresh frozen plasma infusions.[pediatrics.aappublications.org]
  • Treatment may involve diet, medicines and in some cases, surgery.[icdlist.com]

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]

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]
  • 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]
  • In those with diarrhea, an infectious etiology is rarely confirmed. [7] Many studies continue to confirm a high prevalence of inflammatory, malignant, and infectious gastrointestinal disorders in patients with CVID.[ijpmonline.org]

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]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • Pathophysiology of LNH GI mucosal lymphatic tissue consists of inductive and effector compartments [ 23 ].[abdominalkey.com]

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