PMC6475718_01
Colonoscopy finding.. Colonoscopy revealed a submucosal cylindrical formation in the wall of the ascending colon and protruding into the lumen.
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A colonoscopy, performed at the district hospital, revealed a submucosal cylindrical formation in the wall of the ascending colon protruding into the lumen (Fig. 1).
CT examination.. A CT examination showed an encapsulated formation with high attenuation in the inner layer of the bowel wall. The lesion is marked by an arrow in axial image (A) and sagittal image (B).
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A CT scan was performed in arterial, venous and late phase after the administration of iodinated contrast medium in the peripheral vein (Fig. 2).
Operation finding.. After a right hemicolectomy, a lesion located in the intestinal submucosa and protruding into the lumen was confirmed.
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Approximately 13.5 cm of colon without appendix and 6 cm of terminal ileum were removed (Fig. 3).
Histology.. (A) Original magnification x40, haematoxylin and eosin stain. Photomicrograph showed submucosal localization of the cavity lined by the intestinal mucosa. Cavity and native bowel lumen were separated by only a thin layer of submucosal matter. (B) Original magnification x200, haematoxylin and eosin stain. The photomicrograph confirms the absence of the muscularis propria between the inner layer of the cavity (black arrow) and the inner layer of the caecum (white arrow). There was a disruption of the crypt architecture in the inner layer of the cavity with stroma rich in lymphoid tissue.
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There was no communication with native bowel lumen (Fig. 4).