The Clinical Characteristics Of Crohn's Disease And Primary Intestinal Lymphoma

Objective: To identify the main clinical characteristics helpful for differentiating Crohn's disease (CD)from .primary intestinal lymphoma(PIL).Methods:The clinical features, laboratory findings, endoscopic and histological manifestations were investigated retrospectively in 53 cases of CD and 35 cases of PIL.Results:It's difficult to differentiate PIL from CD. The median course in PIL patients(4.5monthes) was shorter than that in CD (10.41 months). Small intestine was the predilection position both in CD and PIL,but ileocolonic lesion happened more in CD than in PIL. The incidence of extra-intestinal manifestation was 43.34% in CD. Perianal lesion and hepatobiliary diseases were more common in CD than in PIL. Bowel obstruction(P=0.001) and bowel perforation(P=0.037) were more common in patients with CD, however, abdominal mass(P=0.002)and celiac lymphadenectasis(P<0.0001)were more common in PIL. On the abdominal CT or MRI,mucosal flattening(P=0.001)and segmental lesions(P=0.025)were more common in CD than in PIL,however abdominal mass and celiac lymphadenectasis were more common in PIL(P<0.05). Under the endoscopy and histopathology, non-caseating granuloma, segmental lesions, lymphocyte aggregation ,transmural inflammation and fibroplastic proliferation were the characteristics for CD, and nonspecific inflammation and single ulcer were common in PIL.Conclusion:The longer course(over one year),the lesion located in ileo-colon simultaneity,together with perianal lesion and hepatobiliary diseases,mucosal flattening and segmental lesions on CT , and under the endoscopy and histopathology ,mucosal embitterment, non-caseating granuloma, segmental lesions, lymphocyte aggregation ,transmural inflammation and fibroplastic proliferation,may lead to make a diagnosis of CD. Whereas, the shorter course(less half one year), ahdominal mass and celiac lymphadenectasis, single ulcer and intestine tumor did more support to diagnosis PIL.