Problem in Diagnostic Criteria of Crohn's Disease Shino Kamachi 1 , Akinori Iwashita 1 , Tsuneyoshi Yao 2 , Toshihiro Sakurai 2 1Department of Pathology, Fukuoka University Chikushi Hospital 2Department of Gastroenterology, Fukuoka University Chikushi Hospital Keyword: Crohn病 , 類上皮細胞肉芽腫 , 類上皮細胞集団(Cluster) , 病理診断 pp.175-182
Published Date 2001/2/25
DOI https://doi.org/10.11477/mf.1403103110
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 We investigated the incidence of positive epithelioid cell granulomas which is regarded as a main factor in the criteria for the diagnosis of Crohn's disease (preliminary proposal) using biopsy specimens taken from conventional upper gastrointestinal (GI) endoscopy and colonoscopy. The incidence of positive granulomas was 43.3% (colon : 33.9%, upper GI 20.9%) in the initial endoscopic examination. This increased to 56.7% (colon : 42.1%, upper GI 30.7%) after consideration and additional examination. In morphologically different endoscopic lesions, incidence was highest in biopsy specimens taken from active colonic lesions (25.0%) . In conclusion, we suggest that it is unreasonable to rely only on the detection of granulomas for the diagnosis of patients with Crohn's disease. In our view, the diagnosis should also include various morphological and histopathological findings, such as epithelioid cell cluster, microaggregates of histiocytes, and focally enhanced gastritis.

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