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It has been reported that Crohn’s disease initially occurs as tiny aphthoid lesions at the sites of lymphoid follicles in the gastrointestinal tract.1–3 The follicle-associated epithelium (FAE) of the gut-associated lymphoid tissues such as Peyer’s patches (PPs)3,4 is a single layer of epithelial cells covering each follicle and forms a dome between the surrounding villi.3,4 Endoscopic observation of PPs in patients with Crohn’s disease has rarely been performed in clinical settings.1–3,5,6
A total of seven patients with active Crohn’s disease and 19 age- and sex-matched healthy controls were enrolled. Chromoendoscopy was carried out with crystal violet and/or indigo carmine to identify PPs. The FAE on the domes of PPs was examined by magnifying endoscopy. The macroscopic appearance of PPs was classified into two categories, a nodular or convolute elevation pattern (E type, fig …