case_images: PMC5574263_01
case_images: Gross examination of the ileocolonic surgical resection specimen revealed extensive fat wrapping and induration of the peri-ileal and pericolonic adipose tissue (a). Examination of the mucosal surface was relatively unremarkable without evidence of strictures, fistulae, or mucosal ulcers (b).
case_images: CRIPA2017-6793031.001.jpg
case_images: PMC5574263_01_CRIPA2017-6793031.001.jpg
case_images: fig1
case_images: Grossly, the specimen received was composed of a portion of ileum anastomosed to a markedly dilated colon, including the sigmoid colon, and notable for extensive fat wrapping associated with dense, indurated mesenteric adipose tissue, particularly in the mid and distal colon (Figure 1(a)). The wall of the ileum and colon were thickened and edematous but revealed an otherwise unremarkable mucosal surface with no strictures, ulcerations, fissures, fistulas, pseudopolyps, or perforations (Figures 1(b) and 2(a)).
case_images: Involvement of the neoterminal ileum by idiopathic myointimal hyperplasia of the mesenteric veins. A representative low-magnification view of the ileum revealed an unremarkable mucosa and ileal wall (a). On high magnification, the peri-ileal veins demonstrated myointimal hyperplasia (b) as evidenced by elastin staining (c).
case_images: CRIPA2017-6793031.002.jpg
case_images: PMC5574263_01_CRIPA2017-6793031.002.jpg
case_images: fig2
case_images: Histologic evaluation revealed myointimal hyperplasia of the mesenteric veins in the peri-ileal (Figure 2) and pericolic (Figure 3) soft tissue as confirmed by elastin stain as well as significant muscularis propria hypertrophy.
case_images: Paired H&E (a, b) and elastin (c, d) stained high-magnification images of mesenteric vessels in the pericolonic soft tissue. Elastic laminae, visible in the artery (a, c), are absent from the vein (b, d), which shows myointimal hyperplasia.
case_images: CRIPA2017-6793031.003.jpg
case_images: PMC5574263_01_CRIPA2017-6793031.003.jpg
case_images: fig3
case_images: Histologic evaluation revealed myointimal hyperplasia of the mesenteric veins in the peri-ileal (Figure 2) and pericolic (Figure 3) soft tissue as confirmed by elastin stain as well as significant muscularis propria hypertrophy.