Pólipo de Nakamura, un hallazgo extraordinariamente infrecuente / Nakamura polyp, an extraordinarily rare finding

El pólipo mioglandular inflamatorio o de Nakamura es un pólipo muy infrecuente, habiendose descrito en la literatura unos 100 casos. Posee unas características tanto endoscópicas como histológicas específicas, cobrando gran importancia su conocimiento para su diagnóstico adecuado. Es de vital importancia su diagnóstico diferencial con otro tipo de pólipos tanto histológicamente como respecto a su seguimiento endoscópico. Presentamos el caso clínico de un pólipo de Nakamura como hallazgo incidental en una colonoscopia de cribado.(AU)

Biliary obstruction secondary to duodenal follicular lymphoma with papillary involvement.

Duodenal-type follicular lymphoma is a clinical variant of follicular lymphoma located in the intestine, presenting as multiple small polyps. The estimated frequency is 1/7000 people and extraduodenal involvement is rare. It predominantly affects middle-aged women, although some cases of young patients have been published in the literature. They are usually located in the second periampullary portion of the duodenum. It is diagnosed incidentally or after performing an imaging test due to non-specific digestive symptoms (abdominalgia, diarrhea or hyporexia). The prognosis is usually favorable without specific treatment5.

Endoscopic ultrasound-guided resolution of right hydronephrosis secondary to local compression by an inflammatory pancreatic mass.

We present the case of 67 years-old man with unremarkable medical history. He was admitted to our department for abdominal pain compatible with choledocholithiasis associated with acute cholecystitis. ERCP was performed but direct papillary canulation attempts failed by means of conventional sphincterotome. So, pre- cut papillotomy was successfully attempted getting free access to distal choledochus and retrieving a small lithiasis. Unfortunately, the patient developed severe post-ERCP acute pancreatitis.

Nakamura polyp, an extraordinarily rare finding.

The inflammatory myoglandular or Nakamura polyp is a very rare polyp, with about 100 cases having been described in the literature. It has specific endoscopic and histological characteristics, making its knowledge of it very important for its proper diagnosis. Its differential diagnosis with other types of polyps is of vital importance, both histologically and with respect to its endoscopic follow-up. We present the clinical case of a Nakamura polyp as an incidental finding in a screening colonoscopy.

Cecal ameboma and a liver abscess mimicking metastatic colonic cancer. An autochthonous infectious disease in Spain?

We present the case of 52 years-old male without any recent travel. He was admitted to our department for a history of fever and abdominal pain. A CT scan showed a cecal thickening and liver mass with suspected cecal carcinoma with infected necrotic liver metastasis. Although the colonoscopy revealed a bulky submucosal wall thickening with a fibrined ulcer with yellow granulating located in the cecum, the percutaneous drainage revealed a positive PCR for Entamoeba histolytica, with improvement with metronidazole treatment. Ameboma are ulcerative, exophytic, inflammatory masses up to 15 cm in diameter in patients with long standing colonic amoebic infections containing granulation tissue with pseudotumor appearance. It affects less than 1.5% of colonic invasive amebiasis. Moreover, concomitant hepatic amoebic can be observed up to 30%, mimicking colonic cancer with necrotic liver metastasis. Although no epidemiological risk factor for amoebic infection was detected. We therefore highlight the awareness of amoebic infection and different manifestation even in non-endemic areas.