Pneumatosis cystoides intestinalis lesions changing into yellowish plaque-like elastosis lesions during healing.

Abstract

Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by multiple gas-filled cysts in the intestinal wall. The majority of patients with PCI are asymptomatic and have a benign clinical course without treatment. Regular colonoscopic follow-up is not always clinically necessary for PCI; therefore, whether all patients with PCI eventually achieve complete endoscopic resolution remains unclear. We herein present the details of an asymptomatic 58-year-old man diagnosed with PCI in the right colon in 2011 by colonoscopy. We followed him using colonoscopy for 8years without treatment. The PCI lesions gradually changed into multiple flat yellowish plaque-like lesions, and biopsies revealed that these were elastosis, which is a very rare pathological finding in the colon. To our knowledge, only two reports discuss morphological or histological changes similar to those of PCI. Because the development of yellowish plaque-like lesions histologically representing elastosis associated with PCI is an unrecognized entity, we herein discuss its clinical features, endoscopic findings, and histological findings with a literature review.