Volume 88 - 2025 - Fasc.2 - Clinical images
A multifaceted disease
We present a 58-year-old patient hospitalised for
deterioration of the general condition and weight loss.
He has undergone two kidney transplants due to systemic
lupus eythematosus. The last transplant occuring in
2007. His treatment includes immunosuppressants,,
hypocholesterolemic and antihypertensive drugs, a
proton pump inhibitor, acenocoumarol, aciclovir and
vitamins. He hasn’t traveled in recent years.
Post-transplantation lymphoproliferative disorder (PTLD) with rectal involvement
We report the case of a 72-year-old man, with a
history of kidney transplantation eight years ago, who
consulted for rectal bleeding without other symptoms.
The patient underwent a rectosigmoidoscopy and
this examination showed a 9mm rounded ulcerated
rectal lesion classified as such: Paris IIc, JNET III,
KUDO V (Figure 1). The optical diagnosis suggest an
adenocarcinoma with high risk of invasion.
The patient then performed an ultrasound endoscopy
confirming a hypoechoic lesion involving the
avoid difficulties related to post-biopsy fibrosis
that complicates the resection (Figure 1). The
anatomopathological results do not support the
diagnosis of an adenocarcinoma. What is your
diagnosis?
Venous malformations as a rare cause of lower gastrointestinal bleeding in a young patient with Blue Rubber Bleb Nevus Syndrome
We report a case of 19-year-old male who presented
with complaints of recurrent episodes of passage of
black coloured stools since last 2 weeks. The patient
reported that he had multiple blue coloured lesions
in hands, legs and face since childhood. At physical
examination, the lesions were of variable sizes ranging
from 3-10 mm and resembled small bubbles of blue
colouration. Biopsy taken from one of the lesions in
childhood was suggestive of cavernous haemangioma.
Laboratory investigations revealed microcytic
anaemia (haemoglobin 9 g/dL; serum ferritin 22ng/
ml; transferrin saturation 10%) with normal rest of
the laboratory parameters. His stool sample tested
positive for occult blood. Further colonoscopy done
to look for the origin of bleed revealed multiple,
variable sized vascular malformations involving
the colon and visualized distal 10 cm of terminal
ileum without any active bleed. Gastroscopy revealed
multiple vascular malformations in the stomach and
second part of duodenum.
A slobbering appendix
A 71-year-old patient consulted for a screening
colonoscopy because of a history of multiple adenomas.
Last coloscopy was realised 5 years earlier and appendix
was endoscopically normal. His only history was a
cure for bilateral varicose veins. No family history was
recorded.
Colonoscopy revealed a 2 cm dilatation of the
appendicular orifice filled with mucus (Figure 1).
