Case 35. Crohn-like longitudinal colonic ulcer in chronic granulomatous disease (8 y-o M)
         
    Colon surgically resected for intractable ulceration seen in a child of chronic granulomatous disease    
         
   
Key words : 
chronic granulomatous disease, Crohn-like ulcer, Johne disese, tuberculosis    
         
   
opportunistic infection
   
     
 
     
Chronic granulomatous disease is characterized by hereditary neutrophilic dysfunction. The defective neutrophils cannot digest catalase-producing microbes, such as Staphylococcus, E. coli, tuberculous bacilli and fungi.   Non-caseous granulomas are formed in the lamina propria mucosae and submucosa of the colon (HE, low power).
     
 
     
Epithelioid cells are clustered in the granuloma (HE, high power). E. coli antigens are not demonstrated by immunostaining.   Reference case 35A
Johne disease in bovine ileum. Non-caseous granulomas are seen in the gut wall (HE).
     
 
     
Reference case 35A
Acid-fast bacilli (M. paratuberculosis) seen in the granuloma in Johne disease (Ziehl-Neelsen). This bovine gut lesion suggests a mycobacterial infectious etiology of human Crohn's disease.
  Reference case 35B
Tuberculosis in surgically resected colon (65 y-o M). Circumferential ulceration is characteristic of intestinal tuberculosis.