Crohn病と生検

Significance of Biopsy in the Diagnosis of Crohn's Disease

要旨　Crohn病44例に内視鏡直視下大腸生検を施行し，肉芽腫または肉芽腫様病変の出現頻度を検討した．腸結核および潰瘍性大腸炎との鑑別に役立つ主な組織所見について若干の検討を加えた．肉芽腫または肉芽腫様病変は44例中18例（40.9％）に認められた．病変部からの出現頻度は27例中10例（37.0％），非病変部からは35例中11例（31.4％）であった，正常直腸粘膜からの生検標本を連続切片で検討すると11例中9例（81.8％）に，また肛門部病変を有する8例全例に肉芽腫または肉芽腫様病変を証明した．Crohn病における肉芽腫または肉芽腫様病変は，1回の内視鏡検査で多数の粘膜生検標本を採取し，これを連続切片で詳細に検索することにより高率に証明しうると考えられた．

　Biopsy specimens obtained from 44 patients with Crohn's disease were histologically studied, with particular reference to the presence of granulomas and/or granulomatous lesions. These lesions were found in 18 cases (40.9%). Biopsy specimens taken from affected areas of the large intestine in 27 cases, contained epithelioid cell granulomas and/or granulomatous Iesions in 10 cases (37.0%), while those obtained from normal appearing colonic and rectal mucosa in 35 cases, did so in 11 cases (31.4%). Serial sections were made from the biopsy specimens taken from nomal appearing rectal mucosa in 11 cases, showing epithelioid cell granulomas and/or granulomatous lesions in as many as 9 cases (81.8%). Thus, high diagnostic yield is expected to result from the examination of serial sections of multiple biopsy specimens taken from multiple sites.