A Study of the Surgical Pathology of Crohn's Disease and Intestinal Tuberculosis and their Differentiation in Surgical Resections

Namratha, R (2015) A Study of the Surgical Pathology of Crohn's Disease and Intestinal Tuberculosis and their Differentiation in Surgical Resections. Masters thesis, Christian Medical College, Vellore.

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Abstract

AIM OF THE STUDY: To do a detailed study of the pathology of Crohn’s disease and intestinal tuberculosis in surgically resected specimens and identify features useful in differentiating between them. OBJECTIVES: 1. To do a detailed histopathological study of surgically resected specimens of Intestinal tuberculosis and Crohn’s disease in our institution during the period January 2004 to March 2013. 2. To identify the pathological features that are useful in differentiating Intestinal tuberculosis from Crohn’s disease. METHODS: Histological features of 33 resected intestinal specimens of Crohn’s disease and 27 resected specimens of intestinal tuberculosis from the archives of the department of pathology were evaluated retrospectively in detail and compared. The clinical data, laboratory and gross data were reviewed from the files. The final clinical diagnosis in all the cases was confirmed based on a combination of clinical, laboratory and radiological data, follow up and response to treatment. Data was analyzed using SPSS version 16. Comparisons for clinical and histological parameters were carried out using the chi-­‐squared test and Fisher’s exact probability test. The average mean scores and sizes were compared using the T test. The quantitative parameters were compared using Mann Whitney U test. RESULTS: The clinical and gross features in favour of Crohn's disease were a long duration of illness, recurrent illness, abdominal abscesses, fistulae, long strictures, multiple strictures, skip lesions, fistulae and creeping mesenteric fat. The histological features suggestive of Crohn’s disease were a low density of granulomas per section, small and medium sized granulomas with a loose configuration, fissuring ulcers, severe transmural inflammation, cryptitis, crypt rupture, pyloric metaplasia, severe submucosal fibrosis and narrowing with thick walled blood vessels, hypertrophied muscularis mucosa, small regional lymph nodes with granulomas in the smaller lymph nodes. The clinical and gross features more in favour of tuberculosis were a short duration of disease, ascites, short strictures, serosal tubercles and caseating lymph nodes. The histological features suggestive of features are a high density of granulomas per section, large granulomas, confluent granulomas, caseating necrosis, fibrosis around granulomas, ulcers lined by epithelioid histiocytes, fibrosis of the muscularis propria, granulomas in the appendix, lymph nodes with capsular fibrosis and paraamyloid.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Crohn’s disease ; Intestinal tuberculosis ; Granulomas ; Surgical resection.
Subjects: MEDICAL > Pathology
Depositing User: Punitha K
Date Deposited: 19 May 2018 15:16
Last Modified: 22 May 2018 18:11
URI: http://repository-tnmgrmu.ac.in/id/eprint/8007

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