Anus and perianal area
Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 14 April 2013, last major update April 2005
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.
● Anal canal involved in 25% or more of patients with small intestinal Crohn’s and 75% with colonic Crohn’s, but anal complaints usually not presenting symptom
● Symptoms: abscesses, fissures, fistulas, skin tags, ulcers
● May be associated with malignancy late in disease course
● Lesions are suspicious for Crohn’s if present in young person with no other cause for fistula or fissure and characteristic small tight granulomas near mucosa, but cannot diagnose only with anal symptoms
● Internal fistulas are relatively specific for Crohn’s disease
● Small, tight granulomas without necrosis near mucosa
● May lack multinucleated giant cells
● Disseminated tuberculosis: usually caseating granulomas, may be acid-fast positive for bacilli, positive cultures
● Foreign body granulomas
End of Anus and perianal area > Inflammatory diseases > Crohn’s disease
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