Pulse granuloma: a rare condition mimicking a gastric tumor
نویسندگان
چکیده
We report the case of a 60-year-old female patient who reported a one-week history of pain in the left hypochondrium, fever, vomiting, and diarrhea. The physical examination and laboratory tests showed no significant changes. Ultrasound showed a septated cystic mass, alongside the stomach, with thick walls and containing debris, although without any vascularity seen on the Doppler flow study (Figure 1A). For clarification, we performed computed tomography (CT), which identified an expansive parietal lesion in the gastric body, measuring 5.9 × 4.5 cm, with contrast uptake by the walls and septa, especially in the portal phase, together with a hypointense central component without enhancement, suggestive of necrosis (Figure 1B). The diagnostic hypotheses were gastric adenocarcinoma and gastrointestinal stromal tumor. The patient underwent upper gastrointestinal endoscopy, which showed an elevated lesion in the greater curvature of the stomach, with irregular, ulcerated mucosa (Figure 2A). A biopsy yielded inconclusive results, and we opted for resection of the lesion. Histopathological examination of the specimen demonstrated pulse granuloma (Figure 2B). The patient was discharged on the fifth postoperative day, with subsequent outpatient follow-up. Pulse granuloma is a benign lesion that is extremely rare. It was first described in 1969 by Knoblich, who characterized it as lung injury. Lewars described the first oral lesion in http://dx.doi.org/10.1590/0100-3984.2015.0106 Marco Aurélio Sousa Sala, Amanda Nogueira de Sá Gonçalves Ligabô, Mario Carlos Camacho de Arruda, João Maurício Canavezi Indiani, Marcelo Souto Nacif
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