Clinical value of endoscopy and histopathology in differential diagnosis of intestinal tuberculosis and Crohn's disease / 中华消化内镜杂志

ABSTRACT

Objective Clinical values of endoscopy and histopathology in differential diagnosis of Crohn's disease(CD) and intestinal tuberculosis were evaluated by characterising the distinctive diagnostic features of CD and intestinal tuberculosis in surgically resected specimens.Methods To review retrospectively the surgical enterocolonic specimens and to compare the clinical,endoscopic and morphologic features of CD or intestinal tuberculosis.Selected histological parameters were evaluated retrospectively in both 30 cases of CD and intestinal tuberculosis.Results The sensitivity,specificity and accuracy of endoscopy in diagnosis of CD and intestinal tuberculosis were 80.0%,25.6% 49.3% and 86.7%,46.2% 63.8% respectively.The histological characteristic parameters of intestinal tuberculosis were confluent granulomas often with caseous necrosis and thinning submucosa;the features of CD were granulomas without caseous necrosis ,submucosal hyperplasia fissure like ulceration and prominent lymphoid aggregates.Some histopathology similarities of CD and intestinal tuberculosis were found,such as chronic non-specific inflammation of intestinal wall,ulceration,collections of epithelioid histocytes,microgranulomas and transmural inflammation.Conclusions Although distinctive diagnostic features of CD and intestinal tuberculosis were found in their clinical,endoscopical and pathological study.The final differential diagnosis depends largely upon pathology.