Endoscopic identification of Peyer's patches of the terminal ileum in a patient with Crohn's disease.
We presented a 20-year-old patient with Crohn's disease (CD). Colonoscopy revealed longitudinal ulceration in the terminal ileum and rectal aphtoid ulcers. After treatment with mesalamine and total parenteral nutrition, repeat colonoscopy revealed a granular elevated area in the terminal ileum, which appeared as an irregular dome-like elevation with irregularly arranged villi on magnifying endoscopy. Biopsy specimens taken from the region showed microgranulomas and lymphoid hyperplasia. Scanning electron microscopy revealed the presence of M cells, confirming that the area corresponded to Peyer's patches. Peyer's patches by magnifying endoscopy and electron microscopy may provide insights into the pathogenesis of CD.
Department of Internal Medicine, National Nagasaki Medical Center, 2-1001 Kubara, Omura, Nagasaki 856-8562, Japan. hajimei2002@yahoo.co.jp
Hiroshi
H
Ishimoto
Hajime
H
Isomoto
Saburo
S
Shikuwa
Chun-Yang
CY
Wen
Takashi
T
Suematu
Masahiro
M
Ito
Ikuo
I
Murata
Hiromi
H
Ishibashi
Shigeru
S
Kohno
D000328:Adult; D001706:Biopsy; D003424:Crohn Disease / Q000473:pathology*; D020776:Endoscopes, Gastrointestinal; D006801:Humans; D007082:Ileum / Q000473:pathology*; D007413:Intestinal Mucosa / Q000473:pathology / Q000648:ultrastructure; D008297:Male; D008855:Microscopy, Electron, Scanning; D010581:Peyer's Patches / Q000473:pathology* / Q000648:ultrastructure