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Rectal pulse granuloma
T C Pereira1, J W Prichard, M Khalid
1Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, PA 15212, USA.
Abstract:
Pulse granuloma is a rare benign entity, most likely representing a foreign body reaction to vegetable particles. We report a case of a pulse granuloma involving the rectum. The patient presented with a submucosal and intramuscular mass lesion found at routine rectal examination and subsequent colonoscopy. The mass was excised and the microscopic examination revealed acute and chronic inflammatory cells, foreign-body giant cells, vegetable matter, and convoluted hyaline rings and scattered circular structures containing basophilic granules, consistent with pulse granuloma. There are a few reports in the literature of pulse granulomas, with most occurring in the oral cavity or lungs. To the best of our knowledge, this is the first reported example of pulse granuloma in the rectum. Although rare, familiarity with this entity's distinctive histopathologic features may avoid a delay in diagnosis and prevent the expense of distinguishing it from its histologic lookalikes.
Insights
This study reports the first case of pulse granuloma in the rectum, a rare benign condition often caused by vegetable matter. Recognizing its unique features is key to accurate diagnosis and avoiding misidentification with other rectal lesions.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Pulse granuloma is a rare benign condition.
- It is typically a foreign body reaction to vegetable particles, commonly found in the oral cavity or lungs.
Observation:
- A case of pulse granuloma involving the rectum is presented.
- The patient exhibited a submucosal and intramuscular mass lesion during routine rectal examination and colonoscopy.
Findings:
- Microscopic examination of the excised mass revealed characteristic features of pulse granuloma.
- These included acute and chronic inflammatory cells, foreign-body giant cells, vegetable matter, and distinctive hyaline rings and granular structures.
Implications:
- This is the first reported case of rectal pulse granuloma.
- Familiarity with its histopathologic features can prevent diagnostic delays and unnecessary investigations for similar-looking rectal conditions.
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