PMC3764960_01
a Abdominal CT shows marked dilation of the transverse and descending colon with localized high-density areas. b Barium enema examination shows irregular mucosal contours and barium flecks in the transverse and descending colon.
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F1
The CT scan also demonstrated localized high-density areas in the lumen of the transverse and descending colon (fig. 1a). Barium enema examination showed irregular mucosal contours with polyposis in these areas (fig. 1b).
Macroscopic findings of the resected colon. Numerous finger-like polyps aggregating in the transverse and descending colon are evident. The resected surface shows polyps of various sizes in the epithelial layer.
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F2
The cross-section of the tumors showed that narrow strings of tissue were interconnected, forming multiple, variably sized spaces inside the tumors (fig. 2).
Several large and small filiform polyps with arborized fibrovascular stromal tissue have formed, and the surrounding spaces are filled with fecal and mucoid materials. a Low-power view. b High-power view. Active inflammatory lesions accompanied with crypt abscess are found in the mucosa of polyps. The active inflammation is more evident in the transverse colon compared to the descending colon. c High-power view of active inflammatory lesions. d Crypt abscess in the transverse colon. e Histologic features of crypt distortion, loss of the muscularis mucosae, submucosal fibrosis and Paneth cell metaplasia (inset) in the transverse and descending colon. These findings are indicative of UC remission.
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F3
The polyps contained regenerative and hyperplastic muscularis mucosa with an arborized and thickened configuration (fig. 3a, b). Neutrophil infiltration, cryptitis, crypt abscess, which is characteristic of active UC, and Paneth cell metaplasia were found in the transverse colon (fig. 3c, d). Sections through the bowel wall near the mass showed colonic mucosa with regenerative features, including architecturally mildly distorted glands, but without active inflammatory changes (fig. 3e).