Subscribe to RSS
DOI: 10.1055/a-1158-8882
Rectal tonsil: a rare cause of rectal bleeding
![](https://www.thieme-connect.de/media/endoscopy/202012/lookinside/thumbnails/1585_10-1055-a-1158-8882-1.jpg)
A rectal tonsil is a lymphoid follicular hyperplasia of the rectum and a rare cause of rectal bleeding. As it is a benign lesion of uncertain etiology [1] [2], treatment is reserved for symptomatic patients [2].
We present the case of a 21-year-old woman with normal bowel movements who presented with a history of rectal bleeding over a period of 4 months. Digital rectal examination revealed a rectal mass. Colonoscopy revealed circumferential granular involvement of the rectal mucosal surface ([Video 1]). Histology showed a dense lymphoid infiltrate and lymphatic follicles ([Fig. 1]).
Video 1 Colonoscopic appearance of a rectal tonsil before and after treatment with mesalazine.
Quality:
![](https://www.thieme-connect.de/media/endoscopy/202012/thumbnails/10-1055-a-1158-8882-i1585ev1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
Infection [3] and lymphoma were excluded ([Fig. 2]) and a diagnosis of rectal tonsil was made [4]. Excellent clinical and endoscopic response was achieved after a 1-month course of rectal mesalazine administered twice daily ([Fig. 3]). Because the lesion is benign in nature, with transformation into lymphoma being the exception [4], treatment was discontinued. The patient continued asymptomatic at 3-month clinical follow-up.
![](https://www.thieme-connect.de/media/endoscopy/202012/thumbnails/10-1055-a-1158-8882-i1585ev2.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/endoscopy/202012/thumbnails/10-1055-a-1158-8882-i1585ev3.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
Endoscopy_UCTN_Code_CCL_1AD_2AC
Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high
quality video and all contributions are
freely accessible online.
This section has its own submission
website at
https://mc.manuscriptcentral.com/e-videos
Publication History
Article published online:
12 May 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Hong JB, Kim HW, Kang DH. et al. Rectal tonsil: A case report and literature review. World J Gastroenterol 2015; 21: 2563-2567
- 2 Trillo L, Arias M, Iglesias A. et al. Amígdala rectal o hiperplasia folicular linfoide del recto. Radiología 2014; 56: 370-373
- 3 Cramer SF, Romansky S, Hulbert B. et al. The rectal tonsil: a reaction to chlamydial infection?. Am J Surg Pathol 2009; 33: 483-485
- 4 Farris AB, Lauwers GY, Ferry JA. et al. The rectal tonsil: a reactive lymphoid proliferation that may mimic lymphoma. Am J Surg Pathol 2008; 32: 1075-1079