PMC2822316_01
Abdominal computerized tomography shows marked dilatation of the distal ileum and no obstructive lesion.
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F1
A computed tomography was followed, which showed exactly the same findings of ultrasonography (Fig. 1).
Small bowel series shows submucosal tumor at distal ileum, suggesting a lymphoma with aneurysmal dilatations or gastrointestinal stromal tumor.
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F2
According to the small bowel series along with the previous radiologic findings, a lymphoma or gastrointestinal stromal tumor having marked aneurysmal dilatations was suspected (Fig. 2).
There is markedly dilated lumen in the mass in connection with the lumen of afferent loop (arrowhead) and efferent loop with normal ileal mucosa (arrow).
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F3
By dividing the mass longitudinally, we could see a necrotic tumor with nodules on the serosal surface of the diseased ileum having normal looking proximal and distal small intestinal loops attatched to it (Fig. 3).
Result of immunohistochemical staining with HMB-45 is positive (x200).
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F5
After immunohistochemical staining with HMB-45 and S-100, the diagnosis of the malignant melanoma infiltrating to the ileal mucosa was confirmed (Fig. 5).