APHTHA AND LYMPHOID HYPERPLASIA OF THE COLON IN CROHN'S DISEASE-OBSERVATION BY MAGNIFYING COLONOSCOPY-

Abstract

Aphthoid ulcer, known as an early lesion of Crohn's disease, and lymphoid hyperplasia (LH) of the colon were studied with a magnifying colonoscopy in Crohn's disease patients in terms of their incidence, distribution and changes with enteral nutrition (EN) therapy. With magnifying colonoscopy : FUJINON EVC-HM (Maximum magnification×14, focus 8mm), total colonoscopy was performed in 28 Crohn's patients. The incidence and distribution of aphtha and LH were studied as well as changes of those before and after EN therapy. In addition, 40 serial sections of biopsy specimens were used to detect granuloma/granulomatous lesions. The results were as follows; 1. Aphtha and LH were observed in 14 (50.0%) and 12 (44.1%) of 28 Crohn's patients, respectively. 2. On serial sections of specimens biopsied from aphtha and LH, granuloma/granulomatous lesions were his-tologically revealed in 10 (71.4%) of 14 aphthas and 5 (41.7%) of 12 LH. 3. After EN therapy, aphtha disappeared or decreased in number in 6 (75%) of 8 patients, but LH increased in number or progressed to aphtha in 2 (40%) of 5 patients. These results suggested that aphtha and LH observed by magnifying colonoscopy appear to be early lesions of Crohn's disease, and EN therapy was effective to these lesions and may inhibit progression of Crohn's disease.