Colitis cystica profunda concurrent with and differentiated from mucinous adenocarcinoma

Summary and Conclusions

Colitis cystica profunda is a benign lesion characterized by the development of mucus-filled cysts beneath the muscularis mucosae, apparently as a result of ulceration and inflammation of the mucosa with extension through the muscularis mucosae. Generally, this disease is diffuse in the colon and more localized in the rectum.

Colitis cystica profunda and mucinous adenocarcinoma have very similar gross and microscopic characteristics. The differential diagnosis is difficult but must depend upon careful interpretation of the microscopic findings.

This disease is either very rare or seldom recognized. Only 32 cases have been reported in the modern literature, of which 24 were taken from the files of the Armed Forces Institute of Pathology, Washington, D. C.

We have presented here the first reported case in which colitis cystica profunda and mucinous adenocarcinoma have been found in the same lesion of the sigmoid, followed a year later by a lesion of the transverse colon, thought to be carcinoma, but proved to be colitis cystica profunda.

The management of these cases depends primarily upon the experience of the surgeon, the symptoms, and the location of the lesion. In general, those in the colon require radical resection, while those in the rectum, being more localized, often may be properly managed by local excision, provided studies of the biopsy material have ruled out carcinoma.