title: Narrow band imaging with magnifying endoscopy for Peyer's patches in patients with inflammatory bowel disease.
abstract: OBJECTIVE
  Peyer's patches (PPs) play a major role in mucosal immunity, but little is known about their alterations in patients with inflammatory bowel disease (IBD). We aimed to evaluate endoscopic changes of PPs in IBD patients using narrow band imaging with magnifying endoscopy (NBI-ME).
  
  
  METHODS
  Images of PPs using NBI-ME by ileocolonoscopy were consecutively collected. Existence of branch-like structures and the vessel occupancy in the dome lesions of PPs were analyzed. Appearance of the surrounding villi of the domes in PPs was evaluated using a 'villi index' consisting of irregular formation, hyperemia, and altered vascular network pattern. Vascularity of PPs was immunohistologically analyzed by anti-CD34 antibody.
  
  
  RESULTS
  17 patients with Crohn's disease (CD), 43 with ulcerative colitis (UC), and 23 healthy control subjects (HC) were analyzed. Both CD and UC patients had a high prevalence of having branch-like structures and significantly higher vascularity in the dome lesions than HC. The villi indices and vascular widths in the villi were significantly larger in CD and UC patients than in HC.
  
  
  CONCLUSIONS
  Precise examination with NBI-ME characterized alteration of vascular structure in the dome and surrounding villi lesions of PPs not only in CD but also in UC patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hiyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Iijima
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Shinzaki
authors.forename: Akira
authors.initials: A
authors.lastname: Mukai
authors.forename: Takahiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Eri
authors.initials: E
authors.lastname: Shiraishi
authors.forename: Syoichiro
authors.initials: S
authors.lastname: Kawai
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsujii
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003113:Colonoscopy; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000473:pathology*; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D062048:Narrow Band Imaging; D010581:Peyer's Patches / Q000098:blood supply* / Q000648:ultrastructure; D055815:Young Adult