Download PDF
CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2018; 09(04): 196-200
DOI: 10.4103/jde.JDE_48_17
Case Report
Journal of Digestive Endoscopy

Carcinoma Colon in a Patient with Eosinophilic Gastroenteritis

Rachit Agarwal
Departments of Gastroenterology and Pathology, Sir Ganga Ram Hospital, New Delhi, India
,
Piyush Ranjan
Departments of Gastroenterology and Pathology, Sir Ganga Ram Hospital, New Delhi, India
,
Sunita Bhalla
Departments of Gastroenterology and Pathology, Sir Ganga Ram Hospital, New Delhi, India
› Author Affiliations
Further Information

Publication History

Publication Date:
24 September 2019 (online)

   Permissions and Reprints

Abstract

Eosinophilic gastroenteritis is an uncommon disease which can involve all layers of the gastrointestinal tract anywhere from the esophagus to colon. Clinical features depend upon the site of involvement and layer of GI tract involved. It is an inflammatory disease with remitting and relapsing course. We report a case which presented with discharging fecal fistula in lower abdomen after emergency laparotomy. Initial colonoscopy showed stricture with nodularity of the IC junction and biopsy showed features of eosinophilic gastroenteritis. Due to persistence of fistula he underwent right hemicolectomy with illeo-transverse anastomosis. Biopsy from surgical specimen showed well differentiated adenocarcinoma and eosinophilic infiltrate in muscularis. Surveillance colonoscopy done six months later showed ulcer at anastomotic site and biopsy showed features of eosinophilic colitis. The clinical course of this patient circumstantially indicates a linkage of eosinophilic colitis with carcinoma colon. This is the first reported case of association of eosinophilic colitis with carcinoma colon. We discuss in detail the clinical and pathological features of eosinophilic enteritis and possible mechanisms linking eosinophilc enteritis with carcinoma.

KEYWORDS

Adenocarcinoma - colon cancer - eosinophilic gastroenteritis
 

  • REFERENCES

  • 1 Khan S, Orenstein SR. Eosinophilic gastroenteritis. Gastroenterol Clin North Am 2008; 37: 333-48 v
    CrossrefPubMedGoogle Scholar
  • 2 Kellermayer R, Tatevian N, Klish W, Shulman RJ. Steroid responsive eosinophilic gastric outlet obstruction in a child. World J Gastroenterol 2008; 14: 2270-1
    CrossrefPubMedGoogle Scholar
  • 3 Chen MJ, Chu CH, Lin SC, Shih SC, Wang TE. Eosinophilic gastroenteritis: Clinical experience with 15 patients. World J Gastroenterol 2003; 9: 2813-6
    CrossrefPubMedGoogle Scholar
  • 4 Lee CM, Changchien CS, Chen PC, Lin DY, Sheen IS, Wang CS. et al. Eosinophilic gastroenteritis: 10 years experience. Am J Gastroenterol 1993; 88: 70-4
    PubMedGoogle Scholar
  • 5 Jeon EJ, Lee KM, Jung DY, Kim TH, Ji JS, Kim HK. et al. Clinical characteristics of 17 cases of eosinophilic gastroenteritis. Korean J Gastroenterol 2010; 55: 361-7
    CrossrefPubMedGoogle Scholar
  • 6 Jagtap SV, Nikumbh DB, Kshirsagar AY, Ahuja N. Unusual presentation of eosinophilic enteritis as multiple strictures of small intestine. Clin Pract 2012; 2: e24
    CrossrefPubMedGoogle Scholar
  • 7 Otowa Y, Mitsutsuji M, Urade T, Chono T, Morimoto H, Yokoyama K. et al. Eosinophilic gastroenteritis associated with multiple gastric cancer. Eur J Gastroenterol Hepatol 2012; 24: 727-30
    CrossrefPubMedGoogle Scholar
  • 8 Kaijser R. Zur kenntnis der allergischen affektioner desima verdauungskanal von standpunkt desima chirurgen aus. Arch Klin Chir 1937; 188: 36-64
    Google Scholar
  • 9 Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR. Eosinophilic gastroenteritis: A clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut 1990; 31: 54-8
    CrossrefPubMedGoogle Scholar
  • 10 Mueller S. Classification of eosinophilic gastrointestinal diseases. Best Pract Res Clin Gastroenterol 2008; 22: 425-40
    PubMedGoogle Scholar
  • 11 Klein NC, Hargrove RL, Sleisenger MH, Jeffries GH. Eosinophilic gastroenteritis. Medicine (Baltimore) 1970; 49: 299-319
    Google Scholar
  • 12 Pineton De Chambrun G, Gonzalez F, Canva JY, Gonzalez S, Houssin L, Desreumaux P. et al. Natural history of eosinophilic gastroenteritis. Clin Gastroenterol Hepatol 2011; 9: 950-60
    CrossrefPubMedGoogle Scholar
  • 13 Fenoglio LM, Benedetti V, Rossi C, Anania A, Wulhfard K, Trapani M. et al. Eosinophilic gastroenteritis with ascites: A case report and review of the literature. Dig Dis Sci 2003; 48: 1013-20
    CrossrefPubMedGoogle Scholar
  • 14 Chang JY, Choung RS, Lee RM, Locke 3rd GR, Schleck CD, Zinsmeister AR. et al. A shift in the clinical spectrum of eosinophilic gastroenteritis toward the mucosal disease type. Clin Gastroenterol Hepatol 2010; 8: 669-75
    CrossrefPubMedGoogle Scholar
  • 15 Treiber GG, Weidner S. Eosinophilic gastroenteritis. Clin Gastroenterol Hepatol 2007; 5: e16
    CrossrefPubMedGoogle Scholar
  • 16 Lowichik A, Weinberg AG. A quantitative evaluation of mucosal eosinophils in the pediatric gastrointestinal tract. Mod Pathol 1996; 9: 110-4
    PubMedGoogle Scholar
  • 17 Gonsalves N. Food allergies and eosinophilic gastrointestinal illness. Gastroenterol Clin North Am 2007; 36: 75-91 vi
    CrossrefPubMedGoogle Scholar
  • 18 Ullman TA, Itzkowitz SH. Intestinal inflammation and cancer. Gastroenterology 2011; 140: 1807-16
    CrossrefPubMedGoogle Scholar
  • 19 Itzkowitz SH, Yio X. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: The role of inflammation. Am J Physiol Gastrointest Liver Physiol 2004; 287: G7-17
    CrossrefPubMedGoogle Scholar
  • 20 Rutter M, Saunders B, Wilkinson K, Rumbles S, Schofield G, Kamm M. et al. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology 2004; 126: 451-9
    CrossrefPubMedGoogle Scholar
  • 21 Isaacs P, Zissis M. Colonic tuberculosis and adenocarcinoma: An unusual presentation. Eur J Gastroenterol Hepatol 1997; 9: 913-5
    CrossrefPubMedGoogle Scholar
  • 22 Cömert FB, Cömert M, Külah C, Taşcilar O, Numanoǧlu G, Aydemir S. et al. Colonic tuberculosis mimicking tumor perforation: A case report and review of the literature. Dig Dis Sci 2006; 51: 1039-42
    CrossrefPubMedGoogle Scholar
  • 23 Chakravartty S, Chattopadhyay G, Ray D, Choudhury CR, Mandal S. Concomitant tuberculosis and carcinoma colon: Coincidence or causal nexus?. Saudi J Gastroenterol 2010; 16: 292-4
    CrossrefPubMedGoogle Scholar
  • 24 HSalim OE, Hamid HK, Mekki SO, Suleiman SH, Ibrahim SZ. Colorectal carcinoma associated with schistosomiasis: A possible causal relationship. World J Surg Oncol 2010; 8: 68
    CrossrefPubMedGoogle Scholar
  • 25 Zuo L, Rothenberg ME. Gastrointestinal eosinophilia. Immunol Allergy Clin North Am 2007; 27: 443-55
    CrossrefPubMedGoogle Scholar
  • 26 Gleich GJ, Adolphson CR. The eosinophilic leukocyte: Structure and function. Adv Immunol 1986; 39: 177-253
    CrossrefPubMedGoogle Scholar
  • 27 Phipps S, Ying S, Wangoo A, Ong YE, Levi-Schaffer F, Kay AB. et al. The relationship between allergen-induced tissue eosinophilia and markers of repair and remodeling in human atopic skin. J Immunol 2002; 169: 4604-12
    CrossrefPubMedGoogle Scholar
  • 28 Brattain MG, Kimball PM, Pretlow 2nd TG, Pitts AM. Partial purification of human colonic carcinoma cells by sedimentation. Br J Cancer 1977; 35: 850-7
    CrossrefPubMedGoogle Scholar
  • 29 Fernández-Aceñero MJ, Galindo-Gallego M, Sanz J, Aljama A. Prognostic influence of tumor-associated eosinophilic infiltrate in colorectal carcinoma. Cancer 2000; 88: 1544-8
    CrossrefPubMedGoogle Scholar
  • 30 Samoszuk M. Eosinophils and human cancer. Histol Histopathol 1997; 12: 807-12
    PubMedGoogle Scholar