Journal of Clinical Pathology. 2008;61:1119-1121. [Link]
Wilkinson L, De P, Bloxham C.
University Hospital of North Durham, North Road, Durham, UK. email@example.com
Intestinal and extraintestinal complications of Crohnâ€™s disease are well documented. Changes in the connective tissue within the intestinal wall and surrounding tissue including mesenteric fat are characteristically seen in resected and autopsy specimens. A rare and unusually florid mesothelial reaction in the surrounding small bowel serosa of a patient with a 2-year history of Crohnâ€™s ileitis is described. The peritoneal surface of the ileal resection specimen displayed exuberant tubulo-papillary formations of the mesothelium, with superficial invasion of the underlying stroma. The case demonstrates the well-recognised difficult differential diagnosis between a benign mesothelial proliferation and malignant mesothelioma in a novel clinical setting, and the diversity of the extramural manifestations of Crohn’s disease.