Türk Patoloji Dergisi/Turkish Journal of Pathology Olgu Sunumu/Case Report 78 Cilt/Vol. 26, No. 1, 2010; Sayfa/Page 78-81 Received : 23.03.2009 Accepted : 07.05.2009 Correspondence: Gülşah KAYGUSUZ Department of Pathology, Ankara University, Faculty of Medicine, ANKARA, TURKEY E-mail: gulsah@gmail.com Phone: +90 32 30 30 0 Adenomyoma of the Small Intestine: Case Report İnce Barsakta Adenomyom: Olgu Sunumu Cevriye CANSIZ 1 , Gülşah KAYGUSUZ 1 , Işınsu KUZU 1 , Şiyar ERSÖZ 2 , Selçuk HAZİNEDAROğLU 2 Department of 1 Pathology and 2 General Surgery, Ankara University, Faculty of Medicine, ANKARA, TURKEY epithelium with regular basally located nuclei and without atypia or mitotic activity (Figure C). Tere were no pancreatic acini or islets. We did not observe Paneth cells or goblet cells. Immunohistochemistry was performed using antibodies against CK7 (OV-TL2/30, Neomarkers, CA, USA :50), SMA (A4, :300 Neomarkers, CA, USA) and CK20 (Ks20.8, :00 Neomarkers, CA, USA). Immunohistochemistry revealed that SMA was positive in the smooth muscle fbers surrounding the glandular structures (Figure D) while CK7 was difusely positive in the epithelium lining the glands (Figure E) and CK20 was negative (Figure F). DISCUSSION Adenomyoma is a lesion that is characterized by a mixture of glandular structures surrounded by smooth muscle fbers. It has several synonyms such as myoepithelial hamartoma (,2,2,3,5), adenomyomatous hamartoma (4,8) and foregut choristoma (6). Adenomyoma of the small intestine distal to duodenum is very rare. To date, only 26 well documented cases of adenomyoma involving small intestine have been reported in the literature (-24). Eighteen male and eight female patients ranging in age from 2 days to 82 years have been reported. Te lesion frequently causes intussusception, but some cases were INTRODUCTION Adenomyoma is a rare benign lesion of hepatobiliary and gastrointestinal tracts. Most of them have been described in the gallbladder. A few cases have been reported elsewhere in the gastrointestinal tract including the ampullary region, small bowel and stomach (,2,3,25). Adenomyoma of the small intestine distal to the duodenum is very rare. To date, only 26 cases have been reported in the literature. CASE REPORT A 6-year-old male was admitted to the Department of General Surgery due to lower abdominal pain. He had a history of reducible inguinal hernia for two years. Partial small intestinal resection and primary hernia repair were performed. He was discharged from the hospital a week later. Macroscopically, there was a 2.5xx cm nodular, solid submucosal lesion in the small intestine. Ischemic changes were detected in the intestinal wall. Microscopically, the lesion was located within the mucosa and submucosa. It was composed of glandular structures of variable size and shape. Tere were irregular muscular bundles surrounding the glandular structures (Figure A,B). Te glandular structures were lined by cuboidal or tall columnar ÖZ İnce barsakta adenomyoma nadir görülen bir antite olup, glanduler yapılar ve bunların arasına giren düz kas demetlerinin varlığı ile karakterlidir. Büyük oranda periampuller bölge veya ileumda görülür. Literatürde yedi jejunal adenomyoma olgusu bildirilmiştir. Biz burada, inguinal hernisi olan 6 yaşındaki bir erkek hastada herni içerisindeki jejunum submukozasında polipoid lezyon ile karakterize bir olguyu sunmaktayız. Anahtar Sözcükler: Jejunum, Adenomyom, İnguinal herni ABSTRACT Adenomyoma of the small intestine is a rare entity characterized by a mixture of glandular structures with intervening bundles of smooth muscle. It occurs mostly in the periampullary region or ileum. Seven cases of jejunal adenomyoma have previously been reported in the literature. We describe here a 6-year-old male sufering from an inguinal hernia with a polipoid lesion in the submucosa of the jejunum strangulated in hernisac. Key Words: Jejunum, Adenomyoma, Inguinal hernia