[Crohn's diseases. Clinicopathological manifestations and differential diagnosis from enterocolonic tuberculosis]

40 cases of enterocolonic Crohn's disease resected were studied clinico-pathologically and were compared with 53 cases of enterocolonic tuberculosis. There are many symptomatic and morphological overlaps between these two diseases. Nevertheless, fissuring ulcer, widening of submucosa and cobblestone appearance are distinct diagnostic features of Crohn's disease, while caseous necrosis and/or presence of acid fast tubercle bacillus are the hallmark of tuberculosis. Antituberculous therapy may alter the histological characteristic of tuberculosis leading to scarring of the granuloma, yet caseous necrosis never completely disappears even after massive dose of antituberculous therapy. In our series, caseous necrosis in the lymph node and bowel wall was still prominent in 21 cases of enterocolonic tuberculosis having received preoperative antituberculous treatment.