Intestinal Research

Clinical Classification of Colorectal Epithelial Tumors and Proposal for Diagnostic Coding: Hyun Gun Kim, Jin-Oh Kim, Suck-Ho Lee, Chang Kyun Lee, Hyun Soo Kim, Hwang Choi, Dong-Hoon Yang, Bora Keum, Sung Pil Hong, Seong-Eun Kim, Byung Chang Kim, Jeong Eun Shin, Cheol Hee Park, Chang Soo Eun, Tae Il Kim, Dong Il Park, Kyu Chan Huh, Dong Kyung Chang, Seun Ja Park; Intest Res 2011;9(1):1-11. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.1

The Korean Standard Classification of Diseases (KCD), which reflects the International Classification of Diseases (ICD), is a fundamental coding system for the diagnosis of colorectal epithelial tumors. The KCD coding of colorectal lesions is entirely up to the clinician and is based on pathologic reports. However, coding discrepancies have arisen among physicians using the KCD and pathologists using the ICD for Oncology-3 (ICD-O-3). The Korean Society of Pathologists recently proposed a standardized pathology-reporting format and guidelines for the coding of colorectal cancer to decrease these discrepancies among pathologists. However, ICD and ICD-O are simple classification codes based on pathologic reports, and are neither intended nor suitable for indexing of distinct clinical entities. For appropriate diagnostic coding using the KCD, a corrected coding principle based upon pathologic reports is required, and unified coding between KCD and ICD-O is necessary. A standardized pathologic report format and communication with understanding between physicians and pathologists should be established. Additionally, the private medical insurance system for colorectal cancer should be revised to reduce conflicts among patients, clinicians, and insurance companies over the medical coding system. (Intest Res 2011;9: 2-11)

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Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
Clinical Endoscopy.2015; 48(3): 216. CrossRef
Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef
Update on the Proposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I-2)
Eun Sun Jung, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Won Ae Lee, Hee Eun Lee, Sunhoo Park, Jin Hee Sohn, So-Young Jin
Korean Journal of Pathology.2012; 46(5): 443. CrossRef

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Clinical Features of Intestinal Tuberculosis in Recent Ten Years (2001-2010): Joo Yeon Cho, You Sun Kim, Won Wo Park, Tsung Pei Chuan, Hyun Tae Kim, Sang Ryul Lee, Jung Hwan Lee, Jeoung Soep Moon; Intest Res 2011;9(1):12-18. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.12

Abstract PDF

Background/Aims
Intestinal tuberculosis (ITB) evades early diagnosis due to non-specific clinical manifestations and difficulties in confirming the disease process. In the current study, we determined the diagnostic appearance and clinical manifestations of ITB in recent 10 years according to diagnostic guidelines, as proposed by the IBD Study Group of Korean Association for the Study of the Intestinal Diseases (KASID). Methods: Fifty-six patients with ITB who were diagnosed at Seoul Paik Hospital between January 2001 and August 2010 were retrospectively reviewed. The diagnosis of ITB was defined as definite or probable in accordance with the diagnostic guidelines and the clinical features were analyzed in comparison with previous studies involving ITB in Korea. Results: The mean age at the time of diagnosis was 45±15 years (range, 17-71 years). Definite and probable diagnoses were obtained in 29% and 71% of the patients, respectively. Twenty-three percent of the patients had synchronous active pulmonary TB and 14% of the patients had other forms of abdominal TB, such as TB mesenteric lymphadenitis or peritonitis. The most common symptoms were abdominal pain (43%), followed by diarrhea (30%), weight loss (14%). Twenty-seven percent of the patients (15 cases) were asymptomatic and diagnosed on comprehensive health care or post-operative surveillance. Only 2 patients (3.6%) underwent surgery for complications, such as intestinal obstruction and perforation. Conclusions: ITB is still prevalent in Korea; however, in the recent 10 years the symptoms of ITB have been milder than previously reported. In addition, the complication rates of ITB were remarkably decreased, suggesting that early diagnosis of ITB was increased. (Intest Res 2011;9: 0-18)

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Differences in Clinical Manifestations according to the Positivity of Interferon-γ Assay in Patients with Intestinal Tuberculosis
Hye Jin Jung, Young-Ho Kim, You Sun Kim, Seong Yeon Jeong, Sung Won Park, Ji Yeon Seo, Hyemi Jung, Jong Pil Im, Ji Won Kim, Sung Noh Hong, Kuk Lae Lee
Gut and Liver.2016; 10(4): 649. CrossRef
Predictive Factors for Differentiating Between Crohn’s Disease and Intestinal Tuberculosis in Koreans
Yunho Jung, Young Hwangbo, Soon Man Yoon, Hoon Sup Koo, Hyun Deok Shin, Jeong Eun Shin, Hee Seok Moon, Sang Bum Kang, Jeong Rok Lee, Kyu Chan Huh
American Journal of Gastroenterology.2016; 111(8): 1156. CrossRef
Clinical Features of Tuberculous Versus Crohn’s Anal Fistulas, in Korea
Yong-Sung Choi, Do-Sun Kim, Jae-Bum Lee, Jong-Kyu Kim, Hyung-Joong Jung, Seong-Dae Lee, Kee-Ho Song, Doo-Han Lee, Mi-Jung Kim
Journal of Crohn's and Colitis.2015; 9(12): 1132. CrossRef
A Case of Intestinal Tuberculosis with Perianal Fistula Diagnosed after 30 Years
Ji Hyun Cheon, Won Moon, Seun Ja Park, Moo In Park, Sung Eun Kim, Youn Jung Choi, Jong Bin Kim, Hye Jung Kwon
The Korean Journal of Gastroenterology.2013; 62(6): 370. CrossRef
A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl
Ga Young Park, Jae Young Park, Chang Hwi Kim, Jeong Ja Kwak, Jae Ock Park
Korean Journal of Pediatric Infectious Diseases.2013; 20(3): 190. CrossRef
The Changes in Etiology and Clinical Features of Non-Traumatic Small Bowel Perforation
Byeong Gwan Kim, Ji Won Kim, Kook Lae Lee, Jae Kyung Lee, Ji Bong Jeong
Intestinal Research.2012; 10(2): 189. CrossRef

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The Early Diagnostic Accuracy for Gastrointestinal T-cell Lymphoma from a Perspective of Gastroenterologists: Sung Ho Ryu, Jae Hee Cheon, Jin Young Kim, Bo Kyung Kim, Jin Young Yoon, Yoon Suk Jung, Hyun Mi Heo, Jin Ha Lee, Soung Min Jeon, Sung Pil Hong, Tae Il Kim, Won Ho Kim; Intest Res 2011;9(1):19-26. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.19

Abstract PDF

Background/Aims
Primary T-cell lymphoma of the gastrointestinal tract is a very difficult disease entity to diagnose, and has an extremely poor prognosis. The aim of this study was to determine the early diagnostic accuracy for gastrointestinal T-cell lymphoma by gastroenterologists. Methods: Between January 2000 and October 2010, the clinical features of 15 patients with primary gastrointestinal T-cell lymphomas, including endoscopic findings, radiologic diagnosis, endoscopic biopsy findings, and final diagnosis, were retrospectively reviewed. Results: The most common initial presenting symptoms of primary gastrointestinal T-cell lymphomas was abdominal pain (n=11, 73%). The anatomic location of the primary lesion the small bowel (n=8, 53%), colon (n=5, 33%), and stomach (n=3, 20%). There were no cases of T-cell lymphomas diagnosed based on clinical symptoms, radiologic findings, or endoscopic findings without biopsy alone. Pathologic confirmation of T-cell lymphomas by endoscopic examination was achieved in 7 cases (64%) and the remaining cases (n=8, 53%) were diagnosed with T-cell lymphomas based on pathologic examination after surgery. Conclusions: All of the patients with primary T-cell lymphomas of the gastrointestinal tract were diagnosed exclusively by endoscopic or surgical pathologic examainations, suggesting that gastroenterologists should scrutinize and suspect this disease with caution due to atypical gastrointestinal ulcers. (Intest Res 2011;9: 6-26)

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Colonic Diffuse Large B-cell Lymphoma Hidden in Actinomycosis
Sang Hoon Lee, Seung-Joo Nam, Sung Joon Lee, Sung Chul Park, Chang Don Kang, Dae Hee Choi, Jin Myung Park, Seung Koo Lee
The Korean Journal of Gastroenterology.2019; 74(1): 46. CrossRef
A Case of Fungating Type Natural Killer Like T Cell Lymphoma of the Ascending Colon
Chang Seok Lee, Dong Hoon Shin, Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Kyung Won Koh, Byoung Hoon Ji, Su Bum Park
The Korean Journal of Gastroenterology.2014; 64(4): 229. CrossRef

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Factors Affecting Complete Small Bowel Study and Diagnostic Yield in MiroCam^® Capsule Endoscopy: Wonho Jung, Jin Sung Koh, Sung Ho Kim, Sang Ah Lim, Eun Hye Lim, Joon Young Lee, Moon Kyung Joo, Beom Jae Lee, Ji Hoon Kim, Jong Eun Yeon, Jong-Jae Park, Jae Seon Kim, Kwan Soo Byun, Yung-Tae Bak, Sang Woo Lee, Jae Hyun Choi; Intest Res 2011;9(1):27-34. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.27

Abstract PDF: Background/Aims
Mirocam^® capsule endoscopy has been widely used in Korea; however, data with respect to Mirocam^® capsule endoscopy is lacking. We have assessed the factors affecting complete small bowel studies and diagnostic yield in Mirocam^® capsule endoscopic studies. Methods: We retrospectively analyzed 103 cases that were assessed with Mirocam^® capsule endoscopy between June 2007 and February 2010 at Guro Korea University Hospital. Results: The mean age of the 103 cases was 55.47 years (range, 16-99 years) and 67 cases (65%) were male. The indications for capsule endoscopy were hematochezia/melena (77 cases, 74.8%), anemia (8 cases, 7.8%), abdominal pain (12 cases, 11.7%), and miscellaneous (weight loss and chronic diarrhea; 6 cases, 5.8%). The mean stomach transit time was 59.9±88.3 minutes (range, 1-630 minutes) and the mean small bowel transit time was 396.0±131.7 minutes (range, 117-708 minutes). The rate of successfully performing a complete small bowel study was 82.5% (85 cases), and the stomach transit time was a significant factor for a complete small bowel study (OR=0.991, 95% CI= 0.984-0.998, P=0.012). The diagnostic yield was 51.5% (53 cases); visual quality was a significant factor in determining the diagnostic yield (OR=6.776, 95% CI=1.32-34.70, P=0.022). Conclusions: In a Mirocam^® capsule endoscopic study, short stomach transit time was a significant factor affecting completion of the small bowel study. Achieving excellent visual quality by good bowel preparation was a significant factor for improving the diagnostic yield. (Intest Res 2011;9: 0-34)

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Two Cases of Crohn's Disease Presented with Hematochezia in Patients with Hemophilia: Jae Hyun Park, Hyo Jong Kim, Seong Dong Sohn, Young Hwangbo, Jaejun Shim, Jae Young Jang, Seok Ho Dong, Byung Ho Kim, Young Woon Chang, Rin Chang; Intest Res 2011;9(1):35-39. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.35

Abstract PDF: The etiology of Crohn's disease, which is a chronic inflammatory condition that potentially involves any location of the alimentary tract from the mouth to the anus, is unknown. However, there is strong evidence that vascular damage could play a role in the pathogenesis of Crohn's disease. Crohn's disease is mediated by multifocal gastrointestinal infarctions, which occur at an early stage in the disease process. Persistent activation of coagulation in patients with Crohn's disease has been shown. In contrast, hemophilia is an inherited disorder of coagulation. The deficiencies of clotting factors usually involve occult or overt bleeding. The pathogenic mechanisms of Crohn's disease and hemophilia are incompatible. An association between Crohn's disease and hemophilia has not been reported in Korea. We managed 21- and 33-year-old men with Crohn's disease associated with hemophilia, who presented with hematochezia. (Intest Res 2011;9: 9-39)

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A Case of Primary Pneumatosis Cystoides Intestinalis in a Patient with Chronic Abdominal Pain: Joon Suk Kim, Soon Beom Kwon, Won Kim, Yong Jin Jung, Ji Bong Jeong, Ji Won Kim, Byung Kwan Kim, Kook Lae Lee; Intest Res 2011;9(1):40-45. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.40

Abstract PDF

Pneumatosis cystoides intestinalis is a rare phenomenon presenting with multiple gas-filled cysts in the submucosal or subserosal layer of the gastrointestinal tract. Pneumatosis cystoides intestinalis can occur as a primary or secondary disease with an underlying etiology. We recently managed a case of primary pneumatosis cystoides intestinalis in a 42-year-old man with chronic abdominal pain. The case is presented with a review of the literature. (Intest Res 2011;9: 10-45)

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A Case with Primary Pneumatosis Cystoides Treated after Colonoscopic Endoscopic Mucosal Resection
Suk Jae Hahn, Hyoun Woo Kang, Jun Kyu Lee
The Korean Journal of Gastroenterology.2014; 64(2): 119. CrossRef

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A Case of Isolated Ileal Ganglioneuroma: Ju Hyung Song, Byong Duk Ye, Yong Sik Yoon, Mi-Jung Kim, Dong-Hoon Yang, Kee Wook Jung, Kyung-Jo Kim, Jung-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2011;9(1):46-50. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.46

Abstract PDF

Ganglioneuromas of the gastrointestinal tract are rare, but have an established association with genetic disorders, such as the multiple endocrine neoplasia (MEN) syndrome (type 2b) and neurofibromatosis (type 1). However, solitary ganglioneuromas are not associated with an increased risk for MEN 2b, neurofibromatosis type 1, or any other systemic conditions. Ganglioneuromas of the gastrointestinal tract have been reported to predominantly involve the colon and rectum, and are thereby occasionally detected during colonoscopy or surgery. Although there are no characteristic symptoms of solitary ganglioneuromas, symptoms can be induced by solitary ganglioneuromas, such as abdominal pain, bleeding, or obstruction, depending on the location and size. Herein we report a case of a solitary ganglioneuroma of the ileum. A 34-year-old man sought evaluation at our hospital for anemia. The medical and family histories were benign and there was no history of genetic disorders. The evaluation for anemia revealed iron-deficiency anemia and CT enterography revealed a single mass in the ileum. Laparoscopic resection of the lesion was performed and the pathologic examination confirmed an ileal ganglioneuroma. (Intest Res 2011;9: 11-50)

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A Case of Duodenal Ganglioneuroma Manifesting as a Subepithelial Tumor
Dong Chan Joo, Gwang Ha Kim, Chul Byung Chae, So Jeong Lee, Do Youn Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2018; 18(4): 271. CrossRef

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A Case of Hepatosplenic T-cell Lymphoma with Colonic Involvement: Ji Young Choi, Hye Sun Park, Dong Soo Han, Jae Hoon Kim, Yil Sik Hyun, Joong Ho Bae, Chang Soo Eun, Young Ha Oh; Intest Res 2011;9(1):51-55. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.51

Abstract PDF

Hepatosplenic T-cell lymphoma is a rare histologic type of peripheral T-cell lymphoma that usually presents with hepatosplenomegaly, B-symptoms, and often with rapid and aggressive progression. There have been no previous domestic reports of a hepatosplenic T-cell lymphoma involving the colon. We report a case of a 61-year old man with colonic invasion of a hepatosplenic T-cell lymphoma. He presented the sudden onset of fever accompanied by severe pancytopenia and rapid liver enzyme elevation without evidence of lymphadenopathy. Multiple tiny erosions were noted during colonoscopy. In addition, many immature lymphocytes with vague nucleoli, abundant eosinophilic cytosol, and nuclei of small-to-medium size were seen within the sinusoids on liver biopsy. A similar pattern existed on colonic mucosa obtained from colonoscopic biopsy. Thus, with the aid of such a specific clinical presentation and the results of immunohistochemical staining, we made a definitive diagnosis of hepatosplenic T-cell lymphoma with colonic involvement. (Intest Res 2011;9: 12-56)

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A Case of Hepatosplenic T-cell Lymphoma Diagnosed by Bone Marrow Examination
Hee Jin So, Jin Kyung Lee, Young Jun Hong, Seok-Il Hong, Hye Jin Kang, Seung-Sook Lee, Yoon Hwan Chang
Laboratory Medicine Online.2013; 3(2): 104. CrossRef

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A Case of Angiosarcoma in Rectum: Jun Young Lee, Seong Ryeol Oh, Bong Joon Yang, Suck Chei Choi, Won Cheol Park, Keum Ha Choi, Ki Jung Yun; Intest Res 2011;9(1):57-60. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.57

Abstract PDF: Angiosarcoma is a malignant vascular neoplasm that usually involves the skin or soft tissues. A primary rectal angiosarcoma is exceedingly rare. A 77-year-old female was admitted to the hospital for evaluation of constipation and hematochezia. The patient had a history of uterine cervix carcinoma which was treated with surgery and radiation therapy. A colonoscopy revealed a friable, ulceroinfiltrative tumor with multiple hyperemic mucosae in the rectum. Microscopically, the tumor exhibited vasoformative growth with nuclear atypism and numerous mitoses. The tumor cells were strongly positive for CD31, CD34, and Factor VIII. We report a case of rectal angiosarcoma that developed after radiation therapy. (Intest Res 2011;9: 13-60)

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Primary Linitis Plastica of the Colon with Mucinous Adenocarcinoma in Young Woman: Ji Hyun Suh, Hyun Deok Shin, Jeong Eun Shin, Hwan Namgung; Intest Res 2011;9(1):61-65. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.61

Abstract PDF: Adenocarcinoma is the most common pathologic diagnosis, representing >95% of colorectal cancers; mucinous adenocarcinoma (MA) accounts for 10-15% and SRC accounts for 0.1-2.4% of colorectal cancers. MA is defined as a tumor with ≥50% mucin. Patients with MAs have a poor prognosis, a higher proportion of peritoneal metastases, and present at a more advanced stage of disease. Linitis plastica involving the colon and rectum is usually a metastatic lesion from gastric cancer and other organs, such as the prostate, gallbladder, and breast. Primary linitis plastica of the colon is very rare. We managed a case of colon cancer occurring in a 19-year-old female with a histologic diagnosis of mucinous adenocarcinoma and morphologic features of linitis plastica. Herein we report a rare case of primary linitis plastica of the colon with a review of the literature. (Intest Res 2011;9: 14-65)

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An "Omics" Based Survey of Human Colon Cancer (Proteomics): Ki Tae Suk; Intest Res 2011;9(1):66-70. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.66

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