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Melanosis (haemosiderosis) ilei
F N Ghadially1, S A Boone, V M Walley
1Canadian Reference Centre for Cancer Pathology, Ottawa Civic Hospital, Ontario.
Abstract:
We report here a case of melanosis ilei where grossly visible greyish black pigmentation of the ileal mucosa was discovered at autopsy. Light microscopy showed Prussian blue positive pigment granules in macrophages in the lamina propria forming the core of villi. Ultrastructural examination showed that the pigment granules had the morphology of siderosomes which are known to be the electron microscopic equivalent of the haemosiderin granules seen with the light microscope. We know of no previous report where pigmentation of the ileal mucosa was ascribed to the presence of haemosiderin.
Insights
This case report details melanosis ilei, a rare condition causing greyish-black pigmentation of the small intestine lining. Pigment granules identified as haemosiderin were found in macrophages within the ileal villi.
Area of Science:
- Gastroenterology
- Pathology
- Histology
Background:
- Melanosis ilei is a rare condition characterized by dark pigmentation of the ileal mucosa.
- The exact cause and histological basis of melanosis ilei are not fully understood.
Observation:
- Gross examination revealed greyish-black pigmentation of the ileal mucosa during an autopsy.
- Microscopic analysis identified Prussian blue positive pigment granules within macrophages in the lamina propria of the villi.
Findings:
- Ultrastructural examination confirmed the pigment granules were siderosomes, the electron microscopic form of haemosiderin.
- This is the first reported case attributing ileal mucosal pigmentation to haemosiderin deposition.
Implications:
- This finding expands the understanding of melanosis ilei's pathophysiology.
- Highlights the importance of considering haemosiderin in the differential diagnosis of intestinal pigmentation.