Diagnosis of Ulcerative Lesions in Diffuse Small Bowel Diseases Shotaro Nakamura 1 , Koji Ikegami 2 , Motohiro Esaki 2 , Koichi Kurahara 3 , Takanari Kitazono 2 , Takayuki Matsumoto 4 1Department of R/D for Surgical Support System, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan 2Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 3Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan 4Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan Keyword: 小腸びまん性疾患 , T細胞リンパ腫 , SLE , Schönlein-Henoch紫斑病 , GVHD pp.1293-1302
Published Date 2014/8/25
DOI https://doi.org/10.11477/mf.1403114245
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 The endoscopic and radiographic features of ulcerative lesions in representative diffuse small bowel diseases are reviewed. Among the diffuse small bowel lymphomas, enteropathy-associated T-cell lymphoma is characterized by diffuse thickening of the bowel folds with large ulcerative tumors, whereas adult T-cell leukemia/lymphoma tends to appear as a granular mucosa with multiple small ulcers. In patients with systemic lupus erythematosus and eosinophilic gastroenteritis, obvious ulcers are usually absent, although erosions or small ulcers are occasionally observed. In Henoch-Schönlein purpura, multiple irregularly shaped ulcers frequently occur in the duodenum and ileum, whereas in Churg-Strauss syndrome, multiple deep ulcers occur in extensive areas of the small bowel. Graft-versus-host disease predominantly involves the terminal ileum with wide, irregular, and shallow ulcers. For accurate clinical diagnosis of these diffuse small bowel diseases, it is important to understand the above morphological characteristics of the ulcerative lesions in each disease.

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