克罗恩病合并腹壁炎性肌纤维母细胞瘤1例

A case of Crohn's disease combined with inflammatory myofibroblastoma of abdominal wall

炎性肌纤维母细胞瘤(inflammatory myofibroblastoma,IMT)是一种罕见的实体瘤,其病因和发病机制尚不清楚。克罗恩病(Crohn's disease)是一种非特异性肠道炎症性疾病。IMT的临床表现、实验室检查及影像学检查均无明显特异性,诊断困难。国内外暂无克罗恩病与IMT在腹壁的病例报道。中南大学湘雅三医院消化内科于2017年11月21日收治1例克罗恩病合并腹壁IMT的患者。患者反复右下腹腹痛4年,体格检查右下腹可触及一6 cm×5 cm大小包块,完善经肛双气囊小肠镜、小肠CT造影等检查未明确病因,2018年9月12日患者因腹壁包块并发肠瘘行手术治疗,术后恢复良好,经组织病理及免疫组织化学检测确诊为克罗恩病合并腹壁IMT。随访至2020年7月,患者仍规律服用硫唑嘌呤,未出现腹痛、腹胀等不适,生活质量良好。

Inflammatory myofibroblastoma(IMT)is a rare solid tumor,and its etiology and pathogenesis are unclear.Crohn's disease is a non-specific intestinal inflammatory disease.The clinical manifestations,laboratory examinations,and imaging examinations of IMT are not specific,making diagnosis difficult.A case of Crohn's disease combined with IMT of abdominal wall was admitted to the Department of Gastroenterology at the Third Xiangya Hospital,Central South University,on Nov.21,2017.This patient was admitted to our hospital because of repeated right lower abdominal pain for 4 years.A 6 cm×5 cm mass was palpated in the right lower abdomen.After completing the transanal double-balloon enteroscopy and computed tomographic enterography for the small intestinal,the cause was still unidentified.The patient underwent surgery due to an abdominal wall mass with intestinal fistula on Sept.12,2018 and recovered well currently.According to histopathology and immunohistochemistry,he was diagnosed with Crohn's disease combined with IMT.Up to July 2020,the patients still took azathioprine regularly,without abdominal pain,abdominal distension,and other discomfort,and the quality of his life was good.