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PERI-DIVERTICULAR PULSE GRANULOMAS IN THE COLON: A CASE REPORT AND REVIEW OF THE LITERATURE

Aim: To describe the case of pulse granulomas (PG) found in a colonic resection from a 44-year-old female with a previous history of perforated diverticular disease, and to review the literature on extra-oral PGs. We also aimed to document the incidence of PG in our institution. Methods: A sigmoid colectomy specimen was examined with H&E and histochemical stains. Computerised pathology files were searched for reports which included the terms ‘pulse granuloma’ or ‘hyaline rings’ over the past 5 years. Results: Histologically typical PGs were found in the wall and subserosa of the colon, in close proximity to peri-diverticular inflammation. Our files found only three oral and four additional extra-oral PGs in the last 5 years. Discussion: Extra-oral pulse granulomas are distinctly uncommon inflammatory lesions related to vegetable material. Most documented cases in the literature and in our files occurred in perianal areas, or were related to diverticular disease, fistulae or transrectal prostate biopsies.