METHODS
The history called for further investigations, and a computed tomography
scan was performed. The computed tomography revealed an ileocolic
intussusception (Fig.1). The patient underwent a laparoscopic ileocolic
resection, finding an ileocolic intussusception secondary to a polypoid
mass in the terminal ileum 20cm from the ileocecal valve. The patient
recovered without complications.
The outpatient colonoscopy biopsies were inconclusive. The
histopathology of the resected mass revealed an inflammatory fibroid
polyp (IFP), limited to the mucosa and submucosa (Fig.2). It
demonstrated a typical proliferation of spindle shaped cells, with
concentric peri-vascular arrangement (“onion skinning”) dispersed
amongst a mixed inflammatory cell infiltrate rich in eosinophils (Fig.
3A-C). The spindle cells demonstrated positive staining for vimentin and
negative for CD34, Ckit, beta-catenin, Bcl-2, ALK1, SMA and desmin (Fig.
3D). The IFP was diagnosed as the lead point for the ileocolic
intussusception.