New Criteria for Diagnosis of Crohn's Disease: With Special Reference of Non-caseating Epithelioid Cell Granuloma Nobuo Hiwatashi 1 , Hiromitsu Watanabe 1 , Hiroki Maekawa 1 1The Third Department of Internal Medicine, Tohoku University School of Medicine Keyword: Crohn病 , 非乾酪性類上皮細胞肉芽腫 , アフタ様潰瘍 , 腸結核 pp.493-504
Published Date 1996/3/25
DOI https://doi.org/10.11477/mf.1403104112
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 New criteria for diagnosis of Crohn's disease were proposed by Prof. Yao, et al in 1995. By the new criteria, cases having typical major lesions, cobblestone appearance and/or longitudinal ulcers (major findings) can be definitely diagnosed as having Crohn's disease, even in the absence of granuloma. In addition, cases having discrete ulcers or aphthoid ulcers aligned along the length of these lesions on both upper and lower gastrointestinal tracts (minor findings) without major lesions can be definitely diagnosed as Crohn's disease when granulomas are detected. These criteria make it possible to diagnose some cases in the initial or early stage. For cases with only minor findings, it is necessary to obtain many biopsy specimens from both the upper and lower gastroinestinal tract and make serial sections in order to detect granulomas. For cases having granulomas and no major lesions, clinical diagnosis must be made carefully by scrutinizing the clinical course and relying on endoscopic and radiographic findings. Because mucosal granulomas in intestinal tuberculosis are small and atrophic and are similar to those in Crohn's disease it is difficult to differentiate them histologically.

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