PMC5968294_01
CT scan of abdomen without visible calcification of the mesenteric vein and its contributories. Colonic wall thickened.
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F1
A CT scan showed a paralytic ileus with increased thickness of the colonic wall but without signs of threadlike calcification of the mesenteric vein or its tributaries (Fig. 1).
Macroscopic and microscopic pictures of the left-sided colonic wall. a Extensive necrosis of mucosa and submucosa. Red bracket marks area of histology, with von Kossa staining showing extensive calcification of the submucosal area. Original magnification 25x. b Details of venous wall with H&E, CD31, EVG, and Kongo-red staining showing submucosal calcification with luminal narrowing. Immune histology reveals preserved endothelial layer with submucosal calcification without inflammation. c Calcification of the submucosal veins. H&E staining. Original magnification 100x.
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F2
Upon gross examination, a thickened colonic wall, together with a necrotic mucosal epithelium and mural calcifications, suggested a vascular-mediated disease (Fig. 2a, inset). Histologically, the colonic wall showed extensive calcifications of the submucosal layer with long-stretched mucosal ulcerations (Fig. 2a). Interestingly, only submucosal veins showed a subtotal occlusive fibrosis, sclerosis, and calcification (Fig. 2b). The calcification was confirmed by von Kossa stain (Fig. 2c), leading to the rare diagnosis of PC.