Lymphoid hyperplasia of the intestine has been associated with multiple diseases and
symptoms. This study was undertaken to analyze the number and topographical distribution
of the lymphoid follicles. A total of 302 adult consecutive patients were enrolled
when they underwent elective colonoscopy. Standardized pictures from terminal ileum
and colon were taken using video colonoscopes. In each picture, the number, size,
and mucosal elevation of lymphoid follicles were analyzed in relation to histological
and immunological findings and medical history. Lymphoid hyperplasia was found to
be most extensive in the terminal ileum and cecum. Patients with untreated gastrointestinally
mediated allergy (GMA) showed the highest number of lymphoid follicles per visible
field in the terminal ileum (P < 0.001) and cecum (P = 0.003) vs. the control group. Patients with infectious colitis also showed a high
number of lymphoid follicles per endoscopic visible field in the transverse colon
(P = 0.020). The presence of lymphoid hyperplasia is a frequent finding during colonoscopy.
It may indicate an enhanced immunological mucosal response to antigenic stimulation
such as GMA or infection.
References
- 1
Vighi G, Marcucci F, Sensi L. et al .
Allergy and the gastrointestinal system.
Clin Exp Immunol.
2008;
153 Suppl 1
3-6
- 2
Banks P M.
Gastrointestinal lymphoproliferative disorders.
Histopathology.
2007;
50
42-54
- 3
Spahn T W, Kucharzik T.
Modulating the intestinal immune system: the role of lymphotoxin and GALT organs.
Gut.
2004;
53
456-465
- 4
Fujimura Y, Hosobe M, Kihara T.
Ultrastructural study of M cells from colonic lymphoid nodules obtained by colonoscopic
biopsy.
Dig Dis Sci.
1992;
37
1089-1098
- 5
Langman J M, Rowland R.
The number and distribution of lymphoid follicles in the human large intestine.
J Anat.
1986;
149
189-194
- 6
Kenney P J, Koehler R E, Shackelford G D.
The clinical significance of large lymphoid follicles of the colon.
Radiology.
1982;
142
41-46
- 7
Hizawa K, Iida M, Aoyagi K, Fujishima M.
The significance of colonic mucosal lymphoid hyperplasia and aphthoid ulcers in Crohn’s
disease.
Clin Radiol.
1996;
51
706-708
- 8
Capitanio M A, Kirkpatrick J A.
Lymphoid hyperplasia of the colon in children. Roentgen observations.
Radiology.
1970;
94
323-327
- 9
Colon A R, DiPalma J S, Leftridge C A.
Intestinal lymphonodular hyperplasia of childhood: patterns of presentation.
J Clin Gastroenterol.
1991;
13
163-166
- 10
Mukhopadhyay S, Harbol T, Floyd F D, Sidhu J S.
Polypoid nodular lymphoid hyperplasia of the terminal ileum.
Arch Pathol Lab Med.
2004;
128
1186-1187
- 11
Canto J, Arista J, Hernandez J.
[Nodular lymphoid hyperplasia of the intestine. Clinico-pathologic characteristics
in 11 cases].
Rev Invest Clin.
1990;
42
198-203
- 12
Iacono G, Ravelli A, Di Prima L. et al .
Colonic lymphoid nodular hyperplasia in children: relationship to food hypersensitivity.
Clin Gastroenterol Hepatol.
2007;
5
361-366
- 13
Rubio-Tapia A, Hernandez-Calleros J, Trinidad-Hernandez S, Uscanga L.
Clinical characteristics of a group of adults with nodular lymphoid hyperplasia: a
single center experience.
World J Gastroenterol.
2006;
12
1945-1948
- 14
Wakefield A J, Murch S H, Anthony A. et al .
Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental
disorder in children.
Lancet.
1998;
351
637-641
- 15
Kokkonen J.
Lymphonodular hyperplasia on the duodenal bulb indicates food allergy in children.
Endoscopy.
1999;
31
464-467
- 16
Kokkonen J, Karttunen T J.
Lymphonodular hyperplasia on the mucosa of the lower gastrointestinal tract in children:
an indication of enhanced immune response?.
J Pediatr Gastroenterol Nutr.
2002;
34
42-46
- 17
Wakefield A J, Ashwood P, Limb K, Anthony A.
The significance of ileo-colonic lymphoid nodular hyperplasia in children with autistic
spectrum disorder.
Eur J Gastroenterol Hepatol.
2005;
17
827-836
E. KraussMD
Department of Medicine I
University of Erlangen-Nuremberg
Ulmenweg 18
91054 Erlangen
Germany
Fax: +49-9131-8535182
Email: ekaterina.krauss@uk-erlangen.de
