BACKGROUND Double-balloon enteroscopy enables performing numerous small bowel biopsies for pathologic analysis. However, most histopathological characteristics of Crohn's disease are non-specific characteristics. We aimed to explore the small bowel mucosal histopathologic characters of Crohn's disease and identify some disease-specific changes. METHODS We included 253 patients without tumors and grouped them into Crohn's disease, suspected Crohn's disease, and non-Crohn's disease groups. These patients underwent double-balloon endoscopy examination and small bowel biopsy at Renji Hospital, Shanghai. All histopathological sections were reviewed, and > 20 histopathological parameters were assessed. Immunohistochemistry was conducted when necessary. RESULTS There were different forms of granulomatous lymphangitis on the small bowel mucosa in Crohn's disease. They showed as various macrophages or epithelioid cells in the lumina of lymphatics or in the center of the villi with or without evident obstruction. These features were only observed in Crohn's disease patients. Furthermore, they were correlated with granuloma and lymphangiectasia. Additionally, 15 other features showed significant differences among the three groups, and Crohn's disease patients showed an average of almost seven histopathological characteristics. CONCLUSIONS We described the detailed morphologies of granulomatous lymphangitis on the small bowel mucosa and recommend it as a useful histopathological feature for the diagnosis of Crohn's disease. In terms of specificity and sensitivity, it was superior to non-caseating epithelioid granuloma.

中文翻译：

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克罗恩病患者小肠粘膜的微观特征。

背景技术双气囊肠镜检查能够进行大量的小肠活检以进行病理分析。然而，克罗恩氏病的大多数组织病理学特征是非特异性特征。我们旨在探讨克罗恩病的小肠黏膜组织病理学特征，并确定某些疾病特异性变化。方法我们纳入了253例无肿瘤的患者，将其分为克罗恩病，疑似克罗恩病和非克罗恩病。这些患者在上海仁济医院接受了双气囊内窥镜检查和小肠活检。回顾了所有组织病理学切片，并评估了20多个组织病理学参数。必要时进行免疫组织化学。结果在克罗恩病中，小肠粘膜上有不同形式的肉芽肿性淋巴管炎。它们在淋巴管腔或绒毛中心显示为各种巨噬细胞或上皮样细胞，有无明显阻塞。这些特征仅在克罗恩氏病患者中观察到。此外，它们与肉芽肿和淋巴管扩张相关。此外，其他15个特征在三组之间显示出显着差异，克罗恩病患者平均表现出近七个组织病理学特征。结论我们描述了小肠粘膜上肉芽肿性淋巴管炎的详细形态，并建议将其作为诊断克罗恩病的有用组织病理学特征。在特异性和敏感性方面，