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Isolation of Human Lymphatic Endothelial Cells by Multi-parameter Fluorescence-activated Cell Sorting
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Crohn's disease is an obstructive lymphangitis.

Herbert J Van Kruiningen1, Jean-Frederic Colombel2, Pietro Tonelli3

  • 1Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06269, United States.

Journal of Crohn'S & Colitis
|April 13, 2026
PubMed
Summary
This summary is machine-generated.

Crohn's disease is a lymphatic vasculature condition, characterized by granuloma-occluded lymphatics leading to inflammation and tissue changes. This pathology, recognized since 1939, remains underacknowledged in gastroenterology.

Keywords:
Crohn’s diseaseDalziel’s diseaseetiologylymphangitisviruses

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Area of Science:

  • Gastroenterology
  • Pathology
  • Immunology

Background:

  • Crohn's disease has been historically identified as a lymphatic vasculature disorder by pathologists since 1939.
  • Current gastroenterological textbooks and associations largely overlook this lymphatic basis.
  • Published works supporting the lymphatic vascular theory of Crohn's disease are referenced.

Purpose of the Study:

  • To highlight the underrecognized role of lymphatic vasculature in Crohn's disease pathogenesis.
  • To present evidence of lymphatic occlusion by granulomas in Crohn's disease patients.
  • To describe the pathological consequences of lymphatic obstruction.

Main Methods:

  • Review of historical and published works on Crohn's disease and lymphatic vasculature.
  • Analysis of a montage of obstructed lymphatics from Crohn's disease patients.
  • Immunohistochemistry to identify granuloma attachment to lymphatic endothelium.

Main Results:

  • Lymphatics in Crohn's disease patients are occluded by granulomas, focally attached to the endothelium.
  • Granuloma attachment leads to upstream lymphocyte plugs and downstream lymphangiectasia.
  • Observed pathology includes edema, tissue stiffening, and boggy mucosa.

Conclusions:

  • Crohn's disease pathology is directly linked to granuloma-induced lymphatic occlusion.
  • The consequences of lymphatic obstruction explain the characteristic tissue changes in Crohn's disease.
  • The findings support the long-standing view of Crohn's disease as a lymphatic vascular disorder.