Abstract
Eosinophilic colitis is an inflammatory condition in which the wall of the colon becomes infiltrated by eosinophils which stain densely pink on microscopy. It is an uncommon clinical entity which has a long list of differential diagnoses. We present a case of a patient whose biopsy at colonoscopy revealed eosinophilic colitis which led to a delay in the diagnosis and subsequent treatment of colon cancer. A 35-year-old male presented with a six-week history of right lower quadrant abdominal pain associated with diarrhoea and weight loss. Colonoscopy showed an inflamed cecum; computed tomography revealed a small ascitic fluid collection in the right iliac fossa. Biopsy showed eosinophilic colitis, and he was treated conservatively with albendazole and mesalamine. The patient failed to improve over the following month with continued weight loss. A repeat CT scan showed a right iliac fossa mass. A right hemicolectomy was performed with histopathology from the specimen showing mucinous adenocarcinoma. Eosinophilic colitis can mask colon cancer and should be considered a diagnosis of exclusion.
Highlights
The term red herring originates from William Cobbett who described the use of a smoked red herring to distract hunting dogs from their pursuit of a rabbit [1]
This case is that of a patient whose biopsy from colonoscopy revealed eosinophilic colitis which led to a delay in the diagnosis and treatment of colon cancer
When Eosinophilic gastrointestinal disease (EGID) affects the colon, it is termed as eosinophilic colitis (EC)
Summary
The term red herring originates from William Cobbett who described the use of a smoked red herring to distract hunting dogs from their pursuit of a rabbit [1]. Diagnostic errors can have dire consequences for both the patient and the doctor when it leads to a delay in treatment for mitotic processes such as colon cancer [2, 3]. It is critical that doctors should be aware of potential pitfalls in the diagnosis and management of this common condition. Eosinophilic colitis is an inflammatory condition in which the wall of the colon becomes infiltrated by eosinophils which stain densely pink on microscopy. This case is that of a patient whose biopsy from colonoscopy revealed eosinophilic colitis which led to a delay in the diagnosis and treatment of colon cancer. This report highlights potential pitfalls in diagnosing a patient with eosinophilic colitis
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