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2015 ; 94
(49
): e2157
Nephropedia Template TP
gab.com Text
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English Wikipedia
Granulomas as the Most Useful Histopathological Feature in Distinguishing between
Crohn s Disease and Intestinal Tuberculosis in Endoscopic Biopsy Specimens
#MMPMID26656343
Ye Z
; Lin Y
; Cao Q
; He Y
; Xue L
Medicine (Baltimore)
2015[Dec]; 94
(49
): e2157
PMID26656343
show ga
The incidence of Crohn's disease (CD) is increasing in Chinese populations in
whom intestinal tuberculosis (ITB) is prevalent.This study aimed to identify
differential diagnostic microscopic and endoscopic characteristics of CD from
those of ITB.Patients with CD (N?=?52) and patients with ITB (N?=?16) diagnosed
between 2010 and 2013 were identified. Specimens obtained via endoscopy were
analyzed microscopically by a pathologist. The relationship between endoscopic
appearance and histopathological features was analyzed. The ? test, Fisher's
exact probability test, and the Mann-Whitney U test were used.Granulomas were
present in 81.3% of ITB cases and in 67.3% of CD cases (P?=?0.36). Granulomas in
ITB cases were denser than those in CD cases (mean 5.29?±?4.30 vs. 2.46?±?3.50
granulomas per 10 low power fields; each low power field?=?3.80 mm; P?=?0.005).
Granulomas in ITB cases were larger (mean widest diameter, 508?±?314??m; range,
100-1100??m) than those in CD cases (mean widest diameter, 253?±?197??m; range,
50-800??m). Basal plasmacytosis was more common in CD cases than in ITB cases
(77.0% vs. 37.5%, P?=?0.000). Endoscopy findings such as longitudinal ulcer,
aphthous ulcer, and cobblestone appearance were only seen in CD cases (34.6%,
21.2%, and 23.1%, respectively). Granulomas were detected in the majority of
cases with longitudinal ulcers (88.9%). Basal plasmacytosis was exclusively
detected in cases with longitudinal ulcer and a cobblestone
appearance.Characteristics of granulomas maybe the most important distinguishing
features between CD and ITB. However, the histopathological characteristics of
both diseases may overlap on endoscopic biopsy specimens. An accurate diagnosis
should be made that considers clinical, endoscopic features, and pathologic
findings.