Melanosis intestini: case report
© Batistatou et al; licensee BioMed Central Ltd. 2006
Received: 26 January 2006
Accepted: 31 March 2006
Published: 31 March 2006
The term melanosis in the gastrointestinal tract refers to the accumulation of pigment deposits in the mucosa. Melanosis of the colon is not uncommon and has been associated with certain conditions, however melanosis of the small intestine is extremely rare. Herein, we describe a case in which we observed melanosis not only in the colon, but in the terminal ileum as well, associated with the use of anthraceneline laxatives. The clinical significance of this condition is not clear, however Gastroenterologists and Pathologists should be aware of its existence.
The term melanosis coli was initially proposed by Virchow . "Melanosis" is a Greek word denoting any condition characterized by abnormal dark coloration of skin or mucosa. Melanosis, by definition, can be due not only to the deposition of melanin, but of other dark-pigmented granules, such as hemosiderin, lipofuskin, lipofuskin-like pigment or ferrum sulfate as well [1, 3]. Therefore the recently proposed term "pseudomelanosis", which means a "fake melanosis", and is used for dark colouring of a mucosa due to deposition of pigment other than melanin, is probably not appropriate.
Melanosis of the colon is not uncommon and has been associated with the ingestion of anthraceneline laxatives, although it can be observed in patients without such history . Melanosis of the small intestine is an extremely rare finding with only a few cases described in the literature [1, 2, 4]. Melanosis of the duodenum has been associated with several conditions such as chronic renal failure, gastrointestinal bleeding, ingestion of drugs, or folic acid deficiency [1, 2]. There is only one reported case of melanosis of the jejunum, possibly due to ferrous-sulfate administration and vitamin deficiencies , and very few cases of melanosis in the ileum [2, 4]. In the majority of these cases, the pigment was characterized as hemosiderin and/or lipofuscin. In our case the location and morphological characteristics of the pigment were identical in the ileum and the colon, and presumably were due to the long-term ingestion of anthraceneline. The clinical significance of this condition is not clear, however Gastroenterologists and Pathologists should be aware of its existence.
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