혈변을 일으킨 원위부 하행결장에 발생한 폴립양 혈관지방종 1예
A Case of Polypoid Angiolipoma of the Distal Descending Colon as Cause of Hematochezia
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초록
혈관지방종은 성숙한 지방조직과 증식된 혈관으로 구성되어 있는, 피하조직에서 주로 발생하는 양성 종양이다. 대장을 포함한 위장관에서의 발생은 매우 드물며, 지금까지 국내에서는 소장인 근위부 회장에 발생한 1예는 있으나, 대장에 발생한 증례는 보고된 바 없었다. 본 증례는 간헐적 왼쪽 하복부 통증과 혈변을 주소로 내원한 47세 남자에서 조영증강전산화 단층촬영에서 비균질적인 음영의 종괴가 원위부 하행결장에서 보였고, 대장내시경 검사에서 크기가 크고 혈관이 풍부한 폴립양 종괴가 관찰되었으며, 개복수술 후 조직학적 검사에서 혈관지방종으로 최종 진단되었다. 따라서 저자들은 증상을 일으킨 원위부 하행결장에서 발생한 증례를 보고하는 바이다.
Abstract
Angiolipoma is a benign tumor that is mainly observed in the subcutaneous tissue and is composed of mature adipose tissue and proliferative blood vessels. However, the condition is rare in the gastrointestinal tract including the colon. There was a case report of angiolipoma of the proximal ileum but there are no reports of angiolipoma of the colon in Korea. A 47-year-old man, who presented with intermittent left lower quadrant pain and hematochezia, underwent contrast enhancement CT, which revealed a huge mass with inhomogeneous density in the distal descending colon. The colonoscopy viewed a large polypoid mass with vascular engorgement, and a laparotomy was performed urgently due to the persistent abdominal pain, intussusception and hematochezia. The histology examination disclosed a benign angiolipoma. We report this case of symptomatic angiolipoma of the distal descending colon. (Korean J Gastrointest Endosc 2007;34:115-118)
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