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Case Reports
. 2006 May;20(5):357-60.
doi: 10.1155/2006/893928.

Resolution of paraneoplastic collagenous enterocolitis after resection of colon cancer

Hugh J Freeman  1 , Ken W Berean
Affiliations
Case Reports

Resolution of paraneoplastic collagenous enterocolitis after resection of colon cancer

Hugh J Freeman et al. Can J Gastroenterol. 2006 May.

Abstract
in English, French

A 52-year-old woman developed severe watery diarrhea, weight loss, anemia and hypoalbuminemia. A localized colon cancer was detected. Subsequently, extensive collagenous mucosal involvement of the small and large intestine was discovered. After resection of the colon cancer, her symptoms resolved. In addition, resolution of the inflammatory process occurred, including the subepithelial collagen deposits. Despite extensive small and large intestinal involvement, both clinical and histological resolution of collagenous inflammatory disease was evident. Collagenous enterocolitis is an inflammatory process that may represent a distinctive and reversible paraneoplastic phenomenon.

Une femme de 52 ans présentait de graves diarrhées liquides, une perte de poids, de l’anémie et de l’hypoalbuminémie. Un cancer du côlon circonscrit a été décelé. On a ensuite découvert une importante atteinte de la muqueuse collagénique de l’intestin grêle et du gros intestin. Après résection du cancer du côlon, les symptômes ont disparu. De plus, on a observé une résolution du processus inflammatoire, y compris les dépôts de collagène sous-épithélial. Malgré une importante atteinte de l’intestin grêle et du gros intestin, tant la résolution clinique que la résolution histologique de la maladie inflammatoire collagénique étaient évidentes. L’entérocolite collagénique est un processus inflammatoire qui peut constituer un phénomène paranéoplasique distinct et réversible.

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Figures

Figure 1)
Figure 1)
Moderately differentiated colonic adenocarcinoma infiltrating into smooth muscle (*) of the muscularis propria
Figure 2)
Figure 2)
Collagenous enterocolitis. Duodenal mucosa (A) showing markedly thickened subepithelial collagen layer (hematoxylin and eosin stain, original magnification ×100). Trichrome stain of duodenal mucosa (B) highlights the thickened collagen layer (arrows) (Mallory’s trichrome, original magnification ×100)
Figure 3)
Figure 3)
Collagenous enterocolitis. Colonic mucosa (A) showing markedly thickened subepithelial collagen layer (hematoxylin and eosin, original magnification ×100). Trichrome stain of colonic mucosa (B) highlights the thickened collagen layer (arrow) (Mallory’s trichrome, original magnification ×100)
Figure 4)
Figure 4)
Normal duodenal mucosa with return of the subepithelial collagen layer to normal. A Hematoxylin and eosin stain, original magnification ×100; B Mallory’s trichrome, original magnification ×100
Figure 5)
Figure 5)
Normal colonic mucosa with return of the subepithelial collagen layer to normal. A Hematoxylin and eosin stain, original magnification ×100; B Mallory’s trichrome, original magnification ×100
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