Endoscopic Findings and Pathohistological Studies of Granuloma in Biopsy Specimens of Crohn's Disease

It is most important to be able to identify sarcoid-like granuloma pathohistologically in the diagnosis of Crohn's disease. In this study, we examined biopsy specimens from 4 cases, and made about 100 serial sections for each specimen. In 2 out of 4 cases we found many granulomas, whereas the other 2 cases were devoid of such granulomas. The results were as follows: 1 . Granulomas were present in biopsy specimens of small ulcers and aphthoid, ulcers One of these was on early lesion at the early disease stage and the other was an early lesions from a relapsed case. 2. We found two types of"granuloma. One was small in size (5-15μm), had giant cells and epithelioid cells, and was located in the lamina propria mucosae. The other was large in size (15-30μm) and was found in the lamina muscularis mucosae, showing a lymph follicle-like structure. 3. The biopsy specimens of these granulomas showed an edematous stroma, notable dilatation of lymph vessels, and little fibrosis.