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Int J Clin Exp Pathol 2013;6(3):521-523

Case Report
Diverticulitis of multiple diverticulosis of the terminal ileum

Tadashi Terada

Departments of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan

Received September 22, 2012; Accepted December 1, 2012; Epub February 15, 2013; Published March 1, 2013

Abstract: Diverticulosis of the terminal ileum is very rare. We report a case of diverticulitis of multiple diverticula of the terminal ileum. A
67-year-old Japanese woman consulted to our hospital because of abdominal pain and melena. A blood laboratory revealed severe anemia
increased CRP (11.21 mg/dl). The upper and lower gastrointestinal endoscopic examination revealed no significant changes. The colon was
free from diverticulum. CT demonstrated two tumors in the small intestine. PET identified a few shadows identical to the tumors detected by
CT. The clinical diagnosis was small intestinal tumors, particularly malignant lymphoma. Operation was performed, and it revealed multiple
tumor-like masses in the terminal ileum. The ulcers are deep and appeared diverticula. Microscopically, the diverticula were located in the
proper muscle and subserosa. The walls of the diverticula were composed of granulation tissue with heavy lymphocytic and neutrophilic
infiltration. Diverticular mucosal walls were recognized in some areas. The lymphocytes were free from atypia, and no features of malignant
lymphoma were recognized. The pathological diagnosis was severe diverticulitis of multiple diverticula in the terminal ileum. (IJCEP1209021).

Keywords: Terminal ileum, diverticulosis, diverticulitis

Address correspondence to: Dr. Tadashi Terada, Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231, Shimizu-Ku,
Shizuoka, 424-8636, Japan. Tel: 81-54-336-1111; Fax: 81-54-336-1315; E-mail: piyo0111jp@yahoo.co.jp