Case Report
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 15, 2004; 10(18): 2767-2768
Published online Sep 15, 2004. doi: 10.3748/wjg.v10.i18.2767
Endoscopic identification of Peyer’s patches of the terminal ileum in a patient with Crohn’s disease
Hiroshi Ishimoto, Hajime Isomoto, Saburo Shikuwa, Chun Yang Wen, Takashi Suematu, Masahiro Ito, Ikuo Murata, Hiromi Ishibashi, Shigeru Kohno
Hiroshi Ishimoto, Saburo Shikuwa, Hiromi Ishibashi, Department of Internal Medicine, National Nagasaki Medical Center, 2-1001 Kubara, Omura, Nagasaki 856-8562, Japan
Hiroshi Ishimoto, Gastrointestinal Unit, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Jackson 706, 55 Fruit Street, Boston, MA 02114, USA
Hajime Isomoto, Ikuo Murata, Shigeru Kohno, Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, 852-8501, Japan
Chun Yang Wen, Department of Molecular Pathology, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
Takashi Suematu, Central Electroscope Laboratory, Nagasaki University School of Medicine, Nagasaki, 852-8501, Japan
Masahiro Ito, Department of Pathology, National Nagasaki Medical Center, j2-1001 Kubara, Omura, Nagasaki 856-8562, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hajime Isomoto, MD, Gastrointestinal Unit, Massachusetts General Hospital, Jackson 706, 55 Fruit Street, Boston, MA 02114, USA. hajimei2002@yahoo.co.jp
Telephone: +1-617-724-8977 Fax: +1-617-726-3673
Received: January 16, 2004
Revised: January 28, 2004
Accepted: March 18, 2004
Published online: September 15, 2004
Abstract

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.

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