Small bowel pseudomelanosis
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Small bowel pseudomelanosis is benign change of the small bowel that mimics melanin deposition.
| Small bowel pseudomelanosis | |
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| Diagnosis in short | |
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[[File:Small bowel pseudomelanosis. H&E stain.|frameless|Template:Px|alt=]] Small bowel pseudomelanosis - alt -- intermed mag.jpg | |
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| Synonyms | pseudomelanosis duodeni (for duodenum) |
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| LM | dark pigment in the lamina propria macrophages |
| Stains | iron stain +ve |
| Site | small bowel, stomach |
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| Associated Dx | iron deficiency anemia, end-stage renal disease, hypertension |
| Clinical history | iron supplementation |
| Prevalence | rare |
| Endoscopy | +/-dark spots |
| Prognosis | benign |
In the duodenum it is known as pseudomelanosis duodeni.
Pseudomelanosis is described in the stomach, duodenum and jejunum.[1]
General
Associations in a series of 17 individuals:[4]
- Hypertension ~90% of cases.
- Iron supplementation ~75% of cases.
- End-stage renal disease ~60% of cases.
Note:
- The associations are different than for melanosis coli.
Gross/endoscopic
- Dark spots ~35% of cases.[4]
Microscopic
Features:
- Dark pigment in the lamina propria macrophages.
Images
SBP - low mag. (WC/Nephron)
SBP - intermed. mag. (WC/Nephron)
SBP - intermed. mag. (WC/Nephron)
SBP - high mag. (WC/Nephron)
SBP - very high mag. (WC/Nephron)
SBP - intermed. mag. (WC/Nephron)
SBP - high mag. (WC/Nephron)
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Stains
- Prussian blue +ve ~80% of cases.[4]
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Small bowel
A. Stomach, Partial Excision as Part of a Sleeve Gastrectomy: - Stomach wall within normal limits. B. Small Bowel Wall, Partial Excision as Part of a Sleeve Gastrectomy: - Small bowel wall with iron containing macrophages in the mucosa, known as "pseudomelanosis", see comment. - NEGATIVE for active inflammation. - NEGATIVE for dysplasia and NEGATIVE for malignancy. Comment: Pseudomelanosis may be seen in the context of iron supplementation, hypertension and chronic renal failure. The macrophages are positive with an iron stain.
See also
References
- ↑ Rustagi, T.; Mansoor, MS.; Gibson, JA.; Kapadia, CR. (Feb 2015). "Pseudomelanosis of stomach, duodenum, and jejunum.". J Clin Gastroenterol 49 (2): 124-6. doi:10.1097/MCG.0000000000000081. PMID 24492404.
- ↑ de Magalhães Costa, MH.; Fernandes Pegado, Mda G.; Vargas, C.; Castro, ME.; Madi, K.; Nunes, T.; Zaltman, C. (Mar 2012). "Pseudomelanosis duodeni associated with chronic renal failure.". World J Gastroenterol 18 (12): 1414-6. doi:10.3748/wjg.v18.i12.1414. PMID 22493558.
- ↑ Lin, HJ.; Tsay, SH.; Chiang, H.; Tsai, YT.; Lee, SD.; Yeh, YS.; Lo, GH. (Apr 1988). "Pseudomelanosis duodeni. Case report and review of literature.". J Clin Gastroenterol 10 (2): 155-9. PMID 2458404.
- ↑ 4.0 4.1 4.2 Giusto, D.; Jakate, S. (Feb 2008). "Pseudomelanosis duodeni: associated with multiple clinical conditions and unpredictable iron stainability - a case series.". Endoscopy 40 (2): 165-7. doi:10.1055/s-2007-995472. PMID 18253910.