ECP 2023 Abstracts

S203 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 1903-2023. The aim of the paper is to present a particular case of gastric adenomyoma. Methods: A 62-year-old woman presented with a three months his- tory of epigastric pain, nausea and lack of appetite. Abdominal CT and upper gastrointestinal endoscopy revealed a submucosal mass in the gastric antrum. Surgical removal of the lesion was decided for suspi- cion of a gastrointestinal stromal tumour (GIST). Results: At macroscopic examination a 30x26x30 mm nodular mass was seen, which showed a cystic, multilocular appearance on cut sec- tion, with discharge of a transparent, serous liquid. Histology examina- tion showed that the lesion was localized in the submucosa, consisting of multiple ductal structures, some of them cystically dilated, lined by normal-appearing columnar and cuboidal epithelium. The ducts were surrounded by interdigitating bundles of smooth muscle. The adja- cent mucosa appeared normal and no exocrine or endocrine pancreatic tissue was found. Ductal epithelium showed positivity for Keratin19 and CA 19-9 and negativity for Synaptophysin, VSIG and CEA. The smooth muscle cells were reactive for SMA. A diagnosis of gastric adenomyoma was made. Conclusion: Adenomyomas of stomach are asymptomatic or produce non-specific symptoms and can mimic a GIST. The immunoprofile sug- gest they could be a variant of pancreatic heterotopia without exocrine or endocrine component (Heinrich type III). E-PS-06-040 Mycobacterial infection mimicking Crohn’s disease and malig- nancy: a case report Z. Hamid*, A. Arnaout *St George’s University Hospital, United Kingdom Background & objectives: The intestinal manifestation of Mycobac- terium Tuberculosis (TB) infection can mimic Crohn’s disease and malignancy clinically, and histologically which is often challenging on small biopsies and even on resections. Methods: We report a case of an ileo-caecal mass in a 35-year old Asian male who presented to the Accident and Emergency department with right sided abdominal pain and vomiting. Results: Computerised Tomography (CT) imaging revealed an obstructing ileo-caecal valve mass. A loop ileostomy was performed, and biopsies taken reported a granulomatous moderate active chronic colitis suggestive of Crohn’s disease. A repeat CT scan done a few months later showed an ileo-caecal mass suspicious of a tumour with enlarged lymph nodes. A right hemicolectomy performed showed an obstructing mass with several firm palpable mesenteric lymph nodes. The histology revealed ulceration and transmural active chronic inflam- mation with florid caseating and non-caseating granulomata within the bowel wall and the lymph nodes. Special stain for acid fast bacilli (Ziehl Neelsen) highlighted the organisms within the granulomatous inflammation of the lymph nodes and bowel wall. Conclusion: The case was discussed at the multidisciplinary meeting and on review, a history of pulmonary TB was stated several years ago. This case report emphasises the importance of clinical information in handling, reporting and treating pulmonary and extra-pulmonary TB cases. TB of the intestine should always enter the differential diagnosis in particular where florid granulomata are encountered. E-PS-06-041 Gallbladder leiomyomatosis: a rare incidental finding: a case report S. Hidouri*, M. Hamdani, M. Walha, K. Bel Hadj Ali, Y. Maalej, A. Khabir *Department of Pathology, Habib Bourguiba University Hospital, Medenine, Tunisia Background & objectives: Gallbladder can hide a variety of tumours. The mesenchymal tumour is the rarest. Leiomyoma is a frequent benign mesenchymal tumour. Only a few cases of leiomyoma have been reported. Herein we report the case of discovering an incidental leiomyomatosis. Methods: A 36-year-old female with no significant pathology, no his- tory of uterine leiomyoma, other neoplasms or clinical evidence of immune defect. She was suffering from biliary colic accompanied by vomiting with inflammatory biological syndrome. Transabdominal ultrasonography showed a vesicular thicken-wall measuring 6mm with lithiasis. Cholecystectomy was performed. Results: Gross examination revealed an atrophic mucosa and well- limited white nodular lesions the largest measuring 1,5cm. Histopathological analysis revealed that the nodular aspect was com- posed of spindle cell proliferation with eosinophilic cytoplasm and bland cigar-shaped nuclei, without atypia or mitoses. Immunohistochemical analysis demonstrated that the tumour cells were positive for Alpha-Smooth Muscle Actin and Desmin, but negative for CD117, CD34, anti PS100 and anti LMP1. Conclusion: Although gallbladder leiomyomatosis still extremely rare. It is important to exclude a leiomyosarcoma, a gastrointestinal stro- mal tumour (GIST), an EBV infection associated to a smooth muscle tumour, which is the matter of a good immunohistochemical study. E-PS-06-042 Schistosoma-induced appendicitis: a rare clinical entity – a case report S. Hidouri*, M. Hamdani, S. Chahbani, M. Walha, K. Bel Hadj Ali, A. Khabir *Department of Pathology, Habib Bourguiba University Hospital, Medenine, Tunisia Background & objectives: Schistosomiasis is one of the most wide- spread parasitosis in the world, especially in Sub-Saharan Africa. Appendicitis is an unusual complication of schistosomiasis; it is still infrequently reported. Here we report a case of a Schistosomal appen- dicitis incidentally discovered after appendectomy. Methods: A 29-year-old Nigerian male, with no past medical history, presented an intermittent pain in the lower right quadrant of the abdo- men without fever. The leukocytes count, neutrophils eosinophils and C- reactive protein were not raised. Results: Abdominal ultrasonography revealed a dilated appendix measuring up to 11mm in the transverse dimension. A diagnosis of acute appendicitis was made and an appendectomy was performed. Histological examination revealed an active inflammation in trans- mural with diffuse eosinophils and neutrophils, associated to a schistosomal colonization realizing foreign body granulomas around eggs. The final diagnosis was acute and granulomatous appendicitis associated with schistosoma eggs. Unfortunately, the patient is lost to follow-up. Conclusion: Systematic histological examination is needed in front of all appendectomy specimens that can hide schistosomiasis infection. Even this unusual localization, intestinal schistosomiasis should be considered as a cause of acute appendicitis, especially among patients who have emigrated from or who have visited endemic areas. E-PS-06-043 Histologic analysis of rectal biopsy samples from patients with chronic idiopathic constipation A. Janegova*, M. Neszmeryova, R. Hustak, I. Kopecka, P. Janega *Institute of Pathological Anatomy, Comenius University in Bratislava, Slovakia Background & objectives: Chronic idiopathic constipation (CIC) is a common gastrointestinal disorder often causing significant dis- ability of patients and is therapeutically hardly controllable. The pathophysiologic background of CIC is still unclear. However,