Analysis of oral mucosa erosive-ulcerative lesions by reflectance confocal microscopy.

In vivo Reflectance Confocal Microscopy (RCM) allows to optically biopsy vital tissues, non-invasively and in real time. It results in horizontal virtual slices at a microscopic resolution and correlating with conventional histopathology. The aim of the present work is to describe RCM cellular and architectural findings in oral mucosae affected by erosive-ulcerative diseases, thus highlighting in vivo the wellknown histological peculiarities. A series of conventionally diagnosed Recurrent Aphthous stomatitis (RAS) and Pemphigus Vulgaris (PV) erosive and/or ulcerative oral lesions underwent RCM imaging to establish the application of RCM imaging to this kind of inflammatory non-tumoral lesions. A total of 12 RAS-related lesions and 8 PV-related lesions were considered. RCM imaging was capable to visualize their microscopic peculiarities, mainly inflammatory infiltrate, vessel dilation (RAS) and acantholytic cells, intraepithelial clefts and inflammatory cell carpets (PV). Despite RCM may result unnecessary to diagnose oral lesions referred to RAS and PV, its capability to highlight their main microscopic features could be advantageously used to monitor the healing or worsening of the clinical situation as well as the responsiveness/refractoriness to therapy.

Aphthoid esophageal ulcers in Crohn's disease of ileum and colon.

We report 4 cases of tiny aphthous ulcers of the esophagus occurring in patients with confirmed Crohn's disease of the terminal ileum and the colon. These ulcers presented as small collections of barium surrounded by a radiolucent halo, and were demonstrable on double-contrast radiographs of the esophagus. They were located in the middle and distal thirds of the otherwise normal esophagus. A more advanced stage of Crohn's ileocolitis was present in these patients.

Yersinia enterocolitica colitis in infants: radiographic changes.

Radiographic changes of Yersinia enterocolitica colitis in 3 infants are presented. Findings included superficial aphthoid ulcers, submucosal ulcers, pancolitis (manifested by toxic megacolon), and involvement of the terminal ileum.

Radiologic diagnosis of Crohn disease (with emphasis on its early manifestations).

Crohn disease can affect any part of the gastrointestinal tract. The early manifestations of the disease are readily recognizable in the colon if double-contrast technique is employed. Small bowel and gastroduodenal involvement in the early stages have been less frequently identified, but enteroclysis and double-contrast UGI examination have yielded encouraging results. There is some evidence that failure to utilize the double-contrast barium enema and enteroclysis contributes to delay in diagnosis of Crohn disease. Use of these more sophisticated techniques is encouraged. As follow-up radiography in Crohn disease appears less indicated than previously considered, it is particularly important that initial assessment employs the most sensitive and accurate radiographic techniques available.

Aphthoid ulcerations in gastric candidiasis.

Tiny aphthoid erosions appear to represent the earliest detectable radiographic change in gastric candidiasis. In this report, the radiographic appearance of these lesions is correlated with gross and microscopic pathologic anatomy, and the progression of these ulcerations to deeper linear furrows is illustrated. It is hoped that the detection of the gastric candidiasis at this early stage will hasten therapy, and thus decrease the risk of fulminant infection in the immunocompromised host.