Lipomas and Carcinoid Tumors

Lipomas. Lipomas are benign submucosal tumors. Yellowish in color with a smooth, polypoid bulging surface, they are most frequently found on the Bauhin valve. Unlike with adenomas, microscopic inspection with zoom endoscopy does not reveal a

Table 17.1 Differential diagnoses: ileitis

Tumors

Features

Carcinoid tumor

Diarrhea is a complication

(70% in ileocecal

Bleeding and obstruction are uncommon

region)

Increased 5-HIAA in urine

Lymphosarcoma

Obstruction

Lymphoma

MALT lymphoma

Burkitt lymphoma (Africa)

Leiomyoma

Endoscopic removal possible up to 2 cm (> 2 cm often malignant)

Obstruction

Bleeding

Adenoma

Obstruction

Bleeding

Lipoma

Incidental finding

Hemangioma

Obstruction

Cecal carcinoma

Often initially mistaken for Crohn disease

with fistulas

Inflammation

Features

Lymphoid follicles

More common among young children

of the terminal

Yersinias, adenoviruses, measles, toxoplas-

ileum

mosis, Tbc, etc.

Appendicitis

Highly acute with fever

NSAID colitis

Melena

Hematochezia

Actinomycosis

Fistulas

Radiation ileitis

Occult bleeding

Diarrhea

Sarcoidosis

Usually involves additional organs

Fig. 17.15 Iatrogenic lesion. Polygonal ulcer after rectal mucosectomy.

Fig. 17.14 Venous thrombosis (submu-cosa) following polypectomy (not clinically relevant).

Fig. 17.15 Iatrogenic lesion. Polygonal ulcer after rectal mucosectomy.

Fig. 17.16 Lipomatous valve. Polyplike form on the Bauhin valve with smooth surface and yellowish color.

CT C

t5 c

TO U

CT O

+1 0

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