Abstract

Background: Crohn's disease (CD) can often present initially with ex-traintestinal manifestations and/or perianal disease. Cytol-ogy oft such a lesion helps arrive at the diagnosis. Case: A 27'-year-old woman pre-sented with recurrent, painful, discharging perianal lesions. On examination, multiple perianal abscesses, sinuses, skin tags and healed scars were noted. Fine needle aspiration cytology (FNAC) of the perianal lesions performed as a first line investigation revealed epithelioid granulomas in a sup-purative background. The possibility of tuberculosis vs. ex-traintestinal manifestation of CD was considered. Endo-scopic studies revealed involvement of distal ileum and the entire colon by deep, serpiginous ulcers, internal fistulae and a distorted ileocecal valve. Biopsy of the intestinal lesions re-vealed chronic inflammation, aphthous ulcers and micro-granulomas, favoring a diagnosis of CD. Conclusion: A granulomatous lesion in any location arouses the clinical suspicion of tuberculosis, given its prevalence in the Indian subcontinent. In view of the increasing incidence of CD in our setting, the finding of a perianal, granulomatous lesion on cytology should prompt a workup for CD in addition to the more common granulomatous counterpart, tuberculosis. Perianal aspiration is an underused diagnostic procedure that can help in narrowing the differential diagnostic possi-bilities.

Original languageEnglish
Pages (from-to)1031-1034
Number of pages4
JournalActa Cytologica
Volume54
Issue number5
Publication statusPublished - 01-01-2010

Fingerprint

Granuloma
Crohn Disease
Tuberculosis
Cell Biology
Ileocecal Valve
Aphthous Stomatitis
Fine Needle Biopsy
Ileum
Abscess
Ulcer
Fistula
Cicatrix
Colon
Inflammation
Biopsy
Skin
Incidence

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Histology

Cite this

@article{44b89cb46f5740b2bf9ba92f3d137b5f,
title = "Beware the perianal granuloma! A case report",
abstract = "Background: Crohn's disease (CD) can often present initially with ex-traintestinal manifestations and/or perianal disease. Cytol-ogy oft such a lesion helps arrive at the diagnosis. Case: A 27'-year-old woman pre-sented with recurrent, painful, discharging perianal lesions. On examination, multiple perianal abscesses, sinuses, skin tags and healed scars were noted. Fine needle aspiration cytology (FNAC) of the perianal lesions performed as a first line investigation revealed epithelioid granulomas in a sup-purative background. The possibility of tuberculosis vs. ex-traintestinal manifestation of CD was considered. Endo-scopic studies revealed involvement of distal ileum and the entire colon by deep, serpiginous ulcers, internal fistulae and a distorted ileocecal valve. Biopsy of the intestinal lesions re-vealed chronic inflammation, aphthous ulcers and micro-granulomas, favoring a diagnosis of CD. Conclusion: A granulomatous lesion in any location arouses the clinical suspicion of tuberculosis, given its prevalence in the Indian subcontinent. In view of the increasing incidence of CD in our setting, the finding of a perianal, granulomatous lesion on cytology should prompt a workup for CD in addition to the more common granulomatous counterpart, tuberculosis. Perianal aspiration is an underused diagnostic procedure that can help in narrowing the differential diagnostic possi-bilities.",
author = "Bhat, {Shaila T.} and Hema Kini and Kini, {Anand U.} and Tantry, {Bailur V.}",
year = "2010",
month = "1",
day = "1",
language = "English",
volume = "54",
pages = "1031--1034",
journal = "Acta Cytologica",
issn = "0001-5547",
publisher = "Science Printers and Publishers Inc.",
number = "5",

}

Beware the perianal granuloma! A case report. / Bhat, Shaila T.; Kini, Hema; Kini, Anand U.; Tantry, Bailur V.

In: Acta Cytologica, Vol. 54, No. 5, 01.01.2010, p. 1031-1034.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Beware the perianal granuloma! A case report

AU - Bhat, Shaila T.

AU - Kini, Hema

AU - Kini, Anand U.

AU - Tantry, Bailur V.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Background: Crohn's disease (CD) can often present initially with ex-traintestinal manifestations and/or perianal disease. Cytol-ogy oft such a lesion helps arrive at the diagnosis. Case: A 27'-year-old woman pre-sented with recurrent, painful, discharging perianal lesions. On examination, multiple perianal abscesses, sinuses, skin tags and healed scars were noted. Fine needle aspiration cytology (FNAC) of the perianal lesions performed as a first line investigation revealed epithelioid granulomas in a sup-purative background. The possibility of tuberculosis vs. ex-traintestinal manifestation of CD was considered. Endo-scopic studies revealed involvement of distal ileum and the entire colon by deep, serpiginous ulcers, internal fistulae and a distorted ileocecal valve. Biopsy of the intestinal lesions re-vealed chronic inflammation, aphthous ulcers and micro-granulomas, favoring a diagnosis of CD. Conclusion: A granulomatous lesion in any location arouses the clinical suspicion of tuberculosis, given its prevalence in the Indian subcontinent. In view of the increasing incidence of CD in our setting, the finding of a perianal, granulomatous lesion on cytology should prompt a workup for CD in addition to the more common granulomatous counterpart, tuberculosis. Perianal aspiration is an underused diagnostic procedure that can help in narrowing the differential diagnostic possi-bilities.

AB - Background: Crohn's disease (CD) can often present initially with ex-traintestinal manifestations and/or perianal disease. Cytol-ogy oft such a lesion helps arrive at the diagnosis. Case: A 27'-year-old woman pre-sented with recurrent, painful, discharging perianal lesions. On examination, multiple perianal abscesses, sinuses, skin tags and healed scars were noted. Fine needle aspiration cytology (FNAC) of the perianal lesions performed as a first line investigation revealed epithelioid granulomas in a sup-purative background. The possibility of tuberculosis vs. ex-traintestinal manifestation of CD was considered. Endo-scopic studies revealed involvement of distal ileum and the entire colon by deep, serpiginous ulcers, internal fistulae and a distorted ileocecal valve. Biopsy of the intestinal lesions re-vealed chronic inflammation, aphthous ulcers and micro-granulomas, favoring a diagnosis of CD. Conclusion: A granulomatous lesion in any location arouses the clinical suspicion of tuberculosis, given its prevalence in the Indian subcontinent. In view of the increasing incidence of CD in our setting, the finding of a perianal, granulomatous lesion on cytology should prompt a workup for CD in addition to the more common granulomatous counterpart, tuberculosis. Perianal aspiration is an underused diagnostic procedure that can help in narrowing the differential diagnostic possi-bilities.

UR - http://www.scopus.com/inward/record.url?scp=78650429199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650429199&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:78650429199

VL - 54

SP - 1031

EP - 1034

JO - Acta Cytologica

JF - Acta Cytologica

SN - 0001-5547

IS - 5

ER -