WCIM 2014 SEOUL KOREA 535
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0849 Upper GI Tract
Ectopic Sebaceous Glands in Esophagus
Daeseong Myung1, young Eun Joo1 Chonnam National University Hwasun Hospital, Korea1
The occurrence of ectopic sebaceous glands is not unique to humans. Ectopic seba- ceous glands have been found in various tissues, such as the lips and mouth, external genitalia, parotid glands, eyelashes, and lacrimal caruncle, palms and soles, and tongue.
In humans, this lesion is mostly found in the buccal cavity, urogenital tract, and var- ious organs. Lesions that are located on the lips and in the mouth are referred to as Fordyce’s spots or Fordyce’s disease. The presence of ectopic sebaceous glands in the esophagus was fi rst reported by De La Pava and Pickren in 1962, but there is very little data on this condition. Only a few cases have been reported. Here, we present an interesting and rare case involving tiny lesions scattered throughout the whole esophagus. An asymptomatic 56-year-old man visited our hospital for screening en- doscopic examination. He had no previous history of gastroesophageal refl ux disease, hyperlipidemia, smoking and alcohol ingestion. Laboratory examinations were within normal range. Endoscopic examination showed numerous variable sized, slightly ele- vated yellowish granular lesions, scattered throughout the entire esophagus (fi gure A).
Biopsy from yellowish granular lesions was performed. Histopathological examination revealed the lobules of cells showing microvesicular vacuolization and sebaceous cell differentiation in the lamina propria. There were no abnormalities of overlying squamous epithelium. The diagnosis was compatible with those of ectopic sebaceous glands. He received the annual endoscopic examination without treatment. The endo- scopic follow-up examination after 7 years showed the slight increase in number or size of lesions (fi gure B). He was still asymptomatic.
PS 0850 Upper GI Tract
Gastric Sarcoidosis Accompanied with Non-Specifi c Lymphadenopathy
Sohyeon HONG1, Minsun RYU1, Kwangjin WOO1, Jeongmi LEE1, Heywon YOON1, Chunghyun TAE1, Changmo MOON1, Seongeun KIM1, Hyekyung JUNG1, Sungae JUNG1, Kinam SHIM1
Ewha Womans University School of Medicine, Korea1
Gastric sarcoidosis is a rare disease accounting for 0.1-0.9 % of all sarcoidosis. We report our experience with a patient with lung and stomach sarcoidosis accompanied by an enlarged abdominal lymph nodes. A sixty-year-old female patient visited our hospital with an abnormal chest x-ray. The patient has no smoking history and no noticeable medical history. There were no fever, cough, dyspnea, nor weight changes.
Physical examination showed clear breathing sound and no palpable lymph node. The chest x-ray showed reticular opacity in the right lower lung zone and chest com- puted tomography indicated that it was an interstitial thickening in the right middle and right lower lobes. A soft tissue density nodule, 9 mm in diameter, neighboring inferior pulmonary vein was also found. Furthermore, multiple enlarged lymph nodes were observed in the left gastric vessel area, which could be suspected as metastatic lymphadenopathy of intra-abdominal malignancy. Abdominal computed tomography showed that the enlarged lymph node spanned over left gastric area, splenic artery area, greater omentum, and gastro-colic trunk, with no mass or thickening in the walls of the stomach. Esophagogastroduodenoscopy revealed a satellite-shaped shallow whitish discoloration accompanied by mucosal irregularity in the anterior wall side of lower body and mucosal depression in the greater curvature side of lower body. Biop- sies on both lesions showed chronic active gastritis with foreign-body type granuloma and Sydney grade 1 Helicobacter pylori. Laparoscopic biopsy on intra-abdominal lymph node was conducted. It was negative in mycobacterium tuberculosis and non-tuber- culous mycobacterium, confi rming multiple well-formed non-caseating granulomas, satisfying our diagnosis as sarcoidosis. The patient was prescribes with methylpredni- solone and follow-up CT 6 months after treatment indicated signifi cant improvement.
PS 0851 Upper GI Tract
Hemoclipped Dieulafoy’s Lesion in Giant Duodenal Diverticulum
Jaewon BEOM1, Dohyun KIM1, Changkook PARK1, Hodong KIM1, Seung CHOI1 St.Carollo Hospital, Korea1
Duodenal diverticula are commonly observed in the general population. Although they are usually asymptomatic, complications (obstruction, bleeding, perforation) occasion- ally develop. Massive bleeding should be diagnosed and treated promptly. A 75-year- old man presented with melena. Endoscopy showed fresh blood clots fi lled the giant diverticulum at the second portion of the duodenum. We removed the fresh blood clots and repeatedly washed with water, and a nonpulsatile but continuous fl ow of blood was seen with no visible ulcer. An endoscopic hemoclipping was performed suc- cessfully without complications. Dieulafoy’s lesion as a cause of bleeding is quite rare in the duodenal diverticulum. We report here a case of a bleeding Dieulafoy’s lesion in the duodenal diverticulum treated by endoscopic hemoclipping.
