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.