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Mesothelial reaction in longstanding Crohn's ileitis simulating papillary mesothelioma

L Wilkinson1, P De, C Bloxham

  • 1University Hospital of North Durham, North Road, Durham, UK. lsarkar@talk21.com

Journal of Clinical Pathology
|September 30, 2008
PubMed

Insights

Crohn's disease can cause unusual reactions in the surrounding tissues. This case highlights a rare, florid mesothelial response in the small bowel serosa, complicating diagnosis.

Area of Science:

  • Gastroenterology
  • Pathology
  • Oncology

Background:

  • Crohn's disease (an inflammatory bowel disease) is known for intestinal and extraintestinal complications.
  • Connective tissue changes in the intestinal wall and surrounding mesenteric fat are typical findings in Crohn's disease specimens.

Observation:

  • A rare and florid mesothelial reaction was observed on the small bowel serosa in a patient with a 2-year history of Crohn's ileitis.
  • The ileal resection specimen showed exuberant tubulo-papillary mesothelial formations with superficial stromal invasion.

Findings:

  • The observed mesothelial proliferation presented a diagnostic challenge, mimicking malignant mesothelioma.
  • This case illustrates a novel clinical setting for differentiating benign mesothelial reactions from malignancy.

Implications:

  • The findings underscore the diverse extramural manifestations of Crohn's disease.
  • Recognizing such reactive mesothelial changes is crucial for accurate diagnosis and patient management in Crohn's disease.

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