摘要
To the editor： A 19-year-old man was referred to our institution with a l-month history of iron deficiency anemia andhyperpyrexia. The lowest hemoglobin was 4.0 g/dl and the highest temperature was 40.6℃. The clinical examination was generally unremarkable. His abdomen was nondistended except for mild epigastric tenderness on deep palpation. There were no other specific signs and findings elicited. The laboratory data including the autoantibodies were within reference ranges, except for low hemoglobin. A computed tomography （Figure IA） examination showed a large sessile mass （white arrow） at the lower less curvature of the stomach, and the liver, pancreas, small bowel, and colon were normal. An esophagogastroduodenoscopy was performed and revealed a 6-cm polyp in the prepyloric region of the stomach. It was easy to bleed when touched and the histological examination of the mucosal biopsy specimens showed that there was a polymorphic inflammatory response dominated by eosinophils in the mucosa. The surrounding mucosa was moderately edematous, and there were no other abnormal findings in the stomach. En bloc resection of this 6 cm-5 cm mass （Figure I B） with partial gastrectomy was subsequently performed, and no further symptoms of anemia or hyperpyrexia have occurred following the mass excision during a 4-month follow-up period. Pathological examination （Figure I C） was consistent with inflammatory fibroid polyp （IFP）. In addition, CD34 （Figure I D）, Vimentin （Figure I E）, and CD68 （Figure IF） were positive on imnmnohistochemistry. IFP is a solitary sessile or pedunculated lesion with an inflammatory basis initially reported by Vanek in 1949. The term ＂inflammatory fibroid polyp＂ was proposed by Helwig and Ranier in 1953.2 IFP is occurred mostly in men during the sixth decade of life as a rare mesenchymal benign lesion that may occur throughout the gastric- intestinal tract but most commonly in the stomach and ileum. IFP in the stomach is always located in the antrum or prepyloric region. Histologically, IFP has been found to be characterized by a submucosal lesion with an onion-skin pattern of proliferation of fibroblasts wrapped around small blood vessels, accompanying a marked eosinophilic infiltration, and may be highlighted by imnlunohistochemistry staining for CD34. Since the distinctive structures for diagnosis are located within the submucosa and at the base of the mucosa, the diagnosis may not be possible in most of these polyps by endoscopic biopsy specimen.
To the editor： A 19-year-old man was referred to our institution with a l-month history of iron deficiency anemia andhyperpyrexia. The lowest hemoglobin was 4.0 g/dl and the highest temperature was 40.6℃. The clinical examination was generally unremarkable. His abdomen was nondistended except for mild epigastric tenderness on deep palpation. There were no other specific signs and findings elicited. The laboratory data including the autoantibodies were within reference ranges, except for low hemoglobin. A computed tomography （Figure IA） examination showed a large sessile mass （white arrow） at the lower less curvature of the stomach, and the liver, pancreas, small bowel, and colon were normal. An esophagogastroduodenoscopy was performed and revealed a 6-cm polyp in the prepyloric region of the stomach. It was easy to bleed when touched and the histological examination of the mucosal biopsy specimens showed that there was a polymorphic inflammatory response dominated by eosinophils in the mucosa. The surrounding mucosa was moderately edematous, and there were no other abnormal findings in the stomach. En bloc resection of this 6 cm-5 cm mass （Figure I B） with partial gastrectomy was subsequently performed, and no further symptoms of anemia or hyperpyrexia have occurred following the mass excision during a 4-month follow-up period. Pathological examination （Figure I C） was consistent with inflammatory fibroid polyp （IFP）. In addition, CD34 （Figure I D）, Vimentin （Figure I E）, and CD68 （Figure IF） were positive on imnmnohistochemistry. IFP is a solitary sessile or pedunculated lesion with an inflammatory basis initially reported by Vanek in 1949. The term ＂inflammatory fibroid polyp＂ was proposed by Helwig and Ranier in 1953.2 IFP is occurred mostly in men during the sixth decade of life as a rare mesenchymal benign lesion that may occur throughout the gastric- intestinal tract but most commonly in the stomach and ileum. IFP in the stomach is always located in the antrum or prepyloric region. Histologically, IFP has been found to be characterized by a submucosal lesion with an onion-skin pattern of proliferation of fibroblasts wrapped around small blood vessels, accompanying a marked eosinophilic infiltration, and may be highlighted by imnlunohistochemistry staining for CD34. Since the distinctive structures for diagnosis are located within the submucosa and at the base of the mucosa, the diagnosis may not be possible in most of these polyps by endoscopic biopsy specimen.
