PMC3485763_01
Umbilicated mass at the pylorus.
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fig1
Grossly, the patient had an umbilicated mass in the pylorus (Figure 1) that resembled a pancreatic rest, but otherwise both EGD and flexible sigmoidoscopy were visually normal.
Colonic biopsy from solid organ transplant patient. Sections of the mucosa show interspersed crypts with dilatation lined by flattened epithelium with inflammatory abscess. The cellularity of the surrounding lamina propria is increased (Hematoxylin and Eosin 40x).
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fig2
Histopathologic samples from the sigmoid colon biopsy revealed significant abnormalities including tubular crypts with mild focal distortion with interspersed dilated crypts lined with flattened epithelial cells, intraluminal cellular debris and apoptotic cells (Figure 2).
PMC3485763_02
PMC3485763_03
Biopsy of duodenum showing patchy villous blunting, increased intraepithelial lymphocytes, gastric mucin cell (foveolar) metaplasia, and reactive glandular changes within the crypts. No evidence of vasculitis or granuloma (Hematoxylin and Eosin 20x).
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fig3
Duodenal biopsies (Figure 3) showed small intestinal mucosa with patchy villous blunting, increased intraepithelial lymphocytes, foveolar metaplasia, and reactive epithelial changes within the crypts.