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.
Ishimoto
Hiroshi
H
Department of Internal Medicine, National Nagasaki Medical Center, 2-1001 Kubara, Omura, Nagasaki 856-8562, Japan. hajimei2002@yahoo.co.jp
Isomoto
Hajime
H
Shikuwa
Saburo
S
Wen
Chun-Yang
CY
Suematu
Takashi
T
Ito
Masahiro
M
Murata
Ikuo
I
Ishibashi
Hiromi
H
Kohno
Shigeru
S
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