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Beware the perianal granuloma! A case report
Shaila T Bhat1, Hema Kini, Anand U Kini
1Department of Pathology, Kasturba Medical College, Light House Hill Road, Mangalore 575001, Karnataka, India. shailavenky@gmail.com
Acta Cytologica
|November 9, 2010
Summary
Fine needle aspiration cytology of perianal lesions can diagnose Crohn
Area of Science:
- Gastroenterology and Hepatology
- Pathology
- Surgical Oncology
Background:
- Crohn's disease (CD) diagnosis can be challenging, often presenting with extraintestinal manifestations like perianal disease.
- Cytology of perianal lesions is a valuable tool for early diagnosis of inflammatory bowel disease.
- Granulomatous inflammation on cytology raises suspicion for both tuberculosis and Crohn's disease.
Observation:
- A 27-year-old woman presented with recurrent, painful, discharging perianal lesions.
- Fine needle aspiration cytology (FNAC) revealed epithelioid granulomas in a suppurative background.
- Endoscopic examination showed characteristic ileocolonic lesions of Crohn's disease.
Findings:
- FNAC of perianal lesions demonstrated granulomatous inflammation, suggesting differential diagnoses.
- Intestinal biopsies confirmed chronic inflammation, aphthous ulcers, and microgranulomas consistent with Crohn's disease.
- The case highlights the utility of perianal lesion cytology in diagnosing Crohn's disease.
Implications:
- Perianal fine needle aspiration cytology is an underutilized diagnostic method for Crohn's disease.
- Cytological findings of granulomatous inflammation warrant a workup for Crohn's disease, especially in endemic areas for tuberculosis.
- Early diagnosis through cytology can lead to timely management and improved patient outcomes in Crohn's disease.
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