Pathological Differential Diagnosis of Inflammatory Diseases of the Small Intestine Seiji Haraoka 1 , Akinori Iwashita 1 1Department of Pathology, Chikushi Hospital, Fukuoka University, Fukuoka, Japan Keyword: Crohn病 , 虚血性小腸炎 , 虚血性小腸炎病変 , 腸結核 , 腸管Behcet病 , 腸管型Behcet病 , 単純性潰瘍 pp.489-497
Published Date 2008/4/24
DOI https://doi.org/10.11477/mf.1403101321
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 We gave an outline of macroscopic and microscopic characteristic features of inflammatory diseases of the small intestine such as Crohn's disease, ischemic enteritis (lesion), intestinal tuberculosis, intestinal Behcet disease, and simple ulcer, including important pathological features for the differential diagnosis. The characteristic findings of Crohn's disease are longitudinal ulcer, cobblestone appearance, non-caseating epithelioid cell granuloma, transmural inflammation, and fissure. The former 3 findings are relatively specific and their combination is important for pathological diagnosis of Crohn's disease. Because the etiology of ischemic enteritis is multifactorial, the diagnosis of ischemic enteritis needs not only the characteristic histological features of ischemic enteritis in the acute or chronic phase but also clinical information. Intestinal tuberculosis typically involves the ileocecal region and reveals a circular ulcer. The confirmation of caseating epithelioid cell granulomas or acid-fast bacilli enables a definite diagnosis of intestinal tuberculosis. In intestinal Behcet disease and simple ulcer, the main ulcers characteristically occur in the ileocecal valve and the satellite ulcers frequently involve the terminal ileum. It is important to have a clear grasp of the characteristic pathological features in addition to clinical information for the differential diagnosis of inflammatory diseases of the small intestine.

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