Gastro-duodenal Crohn's Disease with a Long History of Colonic Crohn's Disease, Repoft of a Case: Histopathological examination of the resected stomach and wedge blopsy of the liver Kenji Kawaguchi 1 , Michio Maruyama 1 , Toichiro Takizawa 1 , Morio Koike 1 , Hitoshi Nakajima 2 , Tsuyoshi Tajima 3 1Department of Pathology, Tokyo Metropolotan Komagome Hospital 2Department of Internal medicine, Tokyo Metropolotan Komagome Hospital 3Department of Endoscopy, Tokyo Metropolotan Komagome Hospital pp.201-207
Published Date 1986/2/25
DOI https://doi.org/10.11477/mf.1403110121
  • Abstract
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 Resected stomach and wedge bipsy of the liver obtained from a 31year-old man with a long history of Crohn's disease of the colon were histologically examined. Pathological findillgs were as follows:

 1) Duodenal ulcer showed scar of fissuring ulcer and irregularly-shaped abscess transversely extending to submucosal layer. Macroscopical features and many microscopical epithelioid cell granulomas were compatible with Croh's disease.

 2) By means of serial cutting method of the stomach, diffuse distribution of millute foci which showed destruction of foveolar neck with mononuclear cell infiltration and epithelioid cell granuloma was evidenced in the gastric mucosa, including pyloric and fundic gland area. Partly mononuclear cell in filtration around the destructed foveolar neck showed a relationship with epithelioid cell granuloma by serial sections.

 3) Some epithelioid cell granulomas with multi-nucleated giant cells were located in lymphatic vessels.

 4) Epithelioid cell granuloma of the portal area was detected in the liver. There was no relation with small duct.

 These findings suggest that Crohn's disease has high frequency of pathological minute foci through gastrointestianl tract and in the liver. Such minute foci in this case might be a characteristic reaction and pathological primary foci of Crohn's disease in the stomach, but not necessarily transform into typical morphological features.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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