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Small Intestinal Adenocarcinoma Involving a Submucosal Ectopic Lymph Node: A Case Report
Ashley L Hein1, Natasha Singh1, Samuel M Cohen1
1Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA.
International Journal of Surgical Pathology
|October 20, 2023
Summary
This study reports a rare case of small intestinal adenocarcinoma involving an encapsulated tertiary lymphoid organ in a patient with Crohn's disease. Further research is needed to understand the prognostic significance of this unusual finding.
Area of Science:
- Gastroenterology
- Oncology
- Immunology
Background:
- Crohn's disease is a chronic inflammatory condition.
- Tertiary lymphoid organs (TLOs) are immune structures that form in chronic inflammation.
- Encapsulated TLOs are exceptionally rare.
Purpose of the Study:
- To report the first known case of small intestinal adenocarcinoma involving a submucosal encapsulated TLO.
- To highlight the potential role of TLOs in gastrointestinal cancers.
- To suggest further investigation into the prognostic implications of TLO involvement in adenocarcinoma.
Main Methods:
- Case report of an 83-year-old male with Crohn's disease.
- Review of histopathology findings from surgical resection.
- Analysis of imaging studies (CT scan).
Main Results:
- The patient presented with symptoms of small intestinal obstruction and was diagnosed with Crohn's disease and papillary renal cell carcinoma.
- Histopathology revealed moderately differentiated small intestinal adenocarcinoma extending into a submucosal encapsulated TLO.
- Twenty mesenteric lymph nodes were negative for carcinoma; the renal mass was Stage I.
Conclusions:
- This is the first documented instance of small intestinal adenocarcinoma involving a submucosal encapsulated TLO.
- The prognostic significance of adenocarcinoma involving TLOs remains uncertain.
- Increased awareness and further studies on intestinal TLOs are warranted.
