The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Gastric and Colonic Submucosal Tumors after the Removal of 51 Anisakis Larvae

51마리의 아니사키스 유충 제거 후 발생한 위와 대장의 점막하종양 1예

  • Cho, Min-Hyoung (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Lee, Sang-Jin (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Joung, Hyoung-Chu (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kang, Jong-Won (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Lee, Kyoung-Won (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kim, Young-Don (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Cheon, Gab-Jin (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • 조민형 (울산대학교 의과대학 강릉아산병원 내과) ;
  • 이상진 (울산대학교 의과대학 강릉아산병원 내과) ;
  • 정형주 (울산대학교 의과대학 강릉아산병원 내과) ;
  • 강종원 (울산대학교 의과대학 강릉아산병원 내과) ;
  • 이경원 (울산대학교 의과대학 강릉아산병원 내과) ;
  • 김영돈 (울산대학교 의과대학 강릉아산병원 내과) ;
  • 천갑진 (울산대학교 의과대학 강릉아산병원 내과)
  • Published : 2012.04.01
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Abstract

A 60-year-old man visited the outpatient clinic complaining of spasmodic abdominal pain. The symptoms had started 4 days previously, within 1 hour of eating sliced raw flatfish (sashimi) and a piece of flatfish gut. Gastroscopy revealed generalized mucosal edema, erythema, multiple erosions, and numerous worms penetrating the gastric mucosa at the greater and lesser curvatures of the middle and lower corpora. Fifty-one worms, 0.5-3 cm in length, were successfully removed with biopsy forceps. Three weeks later, a normal mucosa-covered, 3.5-cm round submucosal tumor (SMT) was found on the greater curvature of the lower corpus and four yellowish, 1-cm SMTs were found on the hepatic flexure of the colon. Histopathological examination revealed marked eosinophilic infiltration in the gastric and colonic mucosa and an eosinophilic abscess in the submucosa. Here, we report a case of eosinophilic granuloma manifesting as SMTs in the stomach and colon after the endoscopic removal of a large number of anisakids.

60세 남자가 광어회와 내장 일부를 먹은 후 발생한 상복부 통증과 오심, 구토를 주소로 내원하였다. 상부위장관 내시경 검사에서 중체부와 하체부의 대만과 소만에 전반적인 점막 부종, 발적, 다발성의 미란이 관찰되었으며, 점막에 깊이 박혀있는 51마리의 아니사키스 유충이 발견되어 생검 겸자로 모두 제거하였다. 3주 후 시행한 상부위장관 내시경에서 체부의 소만과 대만에 1 cm 크기의 점막하종양들이 관찰되었으며, 특히 하체부 대만에 3.5 cm 크기의 타원형의 점막하종양이 관찰되었다. 또한 대장 내시경 검사에서도 간만곡부와 횡행결장에 1 cm 크기의 점막하종양들이 관찰되었다. 위와 대장의 점막하종양에 대한 병리검사소견에서는 위 점막과 대장 점막에 치밀하게 침윤된 호산구들이 관찰되었으며 점막하층에는 호산구성 농양이 관찰되었다. 저자들은 많은 수의 아니사키스 유충을 제거 후 위와 대장에서 점막하종양으로 발현한 호산구성 육아종 1예를 경험하였기에 문헌고찰과 함께 보고한다.

Keywords

References

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  1. Pathogenic Potential of Two Sibling Species, Anisakis simplex (s.s.) and Anisakis pegreffii (Nematoda: Anisakidae): In Vitro and In Vivo Studies vol.2015, pp.None, 2012, https://doi.org/10.1155/2015/983656