PMC4987508_01
A Contrast Enhanced CT scan (coronal view) showing a well-defined bilobed cystic lesion (7.6 x 4.7 x 3.5 cm) involving ileocaecal junction.. B Contrast Enhanced CT scan (axial view) showing the cystic lesion non-communicating with the lumen.
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Tomography (CT) that revealed a well-defined cystic bilobed lesion (7.6 x 4.7 x 3.5 cm) extending from the intramural portion of the medial wall of the caecum to immediately posterior to the ileocaecal junction with multiple enlarged ileocaecal mesenteric lymph nodes (Fig. 1A & 1B).
Gross specimen showing collapsed cyst (non communicating) in the lumen of terminal ileum, Appendix seen.
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It had a flat lining with a focally granular appearance (Fig. 2).
A Microphotograph of the duplication cyst H & E stain, 40 x magnification, showing the ileal mucosa below and the gastric mucosa showing foveolar epithelium with mucous glands beneath. A muscle wall is seen in between which is partially fibrosed.. B Microphotograph of the Appendix showing the reactive follicles suggesting appendicitis.
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Histopathology confirmed a terminal ileal duplication cyst(Fig. 3) with reactive appendicitis and reactive follicular hyperplasia in the involved lymph nodes.
A 400 x resolution histopathology slide showing cyst wall lined by columnar foveolar type gastric epithelium and at places thrown into villiform projections. No goblet cells are seen. Sub-epithelium shows mucous glands.. B 100 x resolution showing gastric mucous lining characterized by columnar foveolar type gastric epithelium. Sub-epithelium shows multiple mucous glands.
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The cyst lining was found to be columnar with villiform projections lined by columnar foveolar type gastric epithelium but no inflammation on high and low resolution (Fig. 4A&B).